Understanding tobacco policy making from local policy makers' point of view: a study of elected Arizona policy makers at the city and county levels

Understanding Tobacco Policy Making From Local Policy Makers' Point of View:
A study of elected Arizona policy makers at the city and county levels
Merrill Eisenberg, Ph.D. Kirsten Elliott Kristie Taylor Ron Woodard Arizona Tobacco Information Network November, 2000
Funded by the Arizona Department of Health Services, Tobacco Education and Prevention Program (TEPP)
Page 1
TABLE OF CONTENTS
I. Purpose Formative Research and Survey Development Identifying Policy Makers and Public Information Survey Distribution and Efforts to Increase Response Rate Confidentiality Data Analysis
II. Methods A. B. C. D. E.
III. Findings A. Background: Who are the Arizona Local Policy Makers? B. Sample Description C. Perceived Locus of Responsibility for Public Health and Tobacco Control D. The Salience of Tobacco Control E. Knowledge and Attitudes About Tobacco and Tobacco Policy F. Who Do You Trust? G. What Types of Information Are Preferred by Local level Policy Makers? H. What Resources Do Policy Makers Have for Gathering and Interpreting Information? I. How Do Local Policy Makers Prefer to Hear From Their Constituents? IV. Conclusion Appendix 1: Information by Local Project Appendix 2: Survey Materials Appendix 3: Classification of Occupations of Municipal Elected Officials
Page 2
I. PURPOSE
The purpose of this study is to provide information describing local level public policy makers and how they approach policy making, so that the local tobacco projects can be better prepared to work with elected officials and meet their informational needs. Specific research questions that are answered by this study include: � � � Who are the local policy makers in Arizona? A basic demographic description of the universe of policy makers is provided. A more detailed description is provided for policy makers who participated in the survey. What is the salience of tobacco use in the overall range of health issues facing local policy makers? The perceived seriousness of tobacco use as a health issue is contrasted with other health issues commonly addressed by local policy makers. What do local policy makers believe about tobacco control and the role of government in public health and tobacco control issues? A description and analysis policy makers' opinions about the role of federal, state, county, city, and citizen initiative in creating public policy for a variety of issues is presented. Opinions about tobacco control policy and the health effects of ETS are also included. Whose opinions most influence local policy makers? The influence of various information sources is described and analyzed. How do local policy makers prefer to hear from their constituents? A description and analysis of contact preferences is provided. What types of information and information formats are preferred by local level policy makers? Preferences for various information sources and formats are described and analyzed. What resources do policy makers have for gathering and interpreting information? Staff availability e- mail/internet capability are assessed. How these resources are used as tools for gathering and interpreting information is described and analyzed.
� � � �
II. METHODS
A. Formative Research and Survey Development
The study began with structured, open-ended interviews with local project directors to identify the range of experiences they have had with local level policy makers. From these interviews, three types of interactions with local policy makers were identified: no interaction, successful interaction, and unsuccessful interaction. We then identified three communities representing each type of interaction in which to conduct more in-depth interviews with policy makers. The communities chosen were Yuma (no interaction), Mesa (successful interaction) and Lake Havasu (unsuccessful interaction). Structured open-ended interviews were conducted by telephone with mayors and council members from Yuma, Mesa, and Lake Havasu. The interview guide used for these is provided as Attachment X. Telephone calls were made to each policy maker in these communities and interviews were either scheduled or conducted at this initial contact. Interviews lasted from 30 to 60 minutes each. In some cases interviews were continued in a second telephone call. Of the 21 local level policy makers in these three communities, twelve completed interviews, including four from Yuma, three from Mesa and five from Lake Havasu. Page 3
Detailed notes were taken during the interviews and these were transcribed and expanded immediately after the interview had been completed. These notes were then organized topically and used to identify questions and response categories for a closed ended survey. The survey was reviewed and tested by individuals who have served as local level policy makers and by other involved in the policy process.
B. Identifying Policy Makers and Public Information
The Local Government Directory (January, 2000) published by the League of Arizona Cities and Towns and the Arizona Association of Counties, lists elected officials in every Arizona county, city, and town. This list included the policy makers' names and contact information. Gender was coded based on first name. The Directory also lists the occupation of all policy makers serving at the city or town level. These were recorded and those who are retired were noted. Those who are retired from or who currently work in education, health care, or the hospitality industry were also noted. The population of the jurisdiction and geographic area within jurisdictional limits were also taken from this source. Population density was calculated based on population and area. For cities and towns, the Directory identifies those that have a councilmanager form of government and those that do not. This information was added to each policy maker's record. Finally, the sales tax rate for cities and towns was collected for each city council member. Political party for each policy maker was obtained by calling the County Recorder in each county and asking for the party affiliation of each individual. Using the above sources, the information we had describing every policy maker was: � gender, � political party affiliation � jurisdiction (city or county), � name of county, � name of city or town for city or town council people, � population, geographic size and population density of the jurisdiction served, � type of government and sales tax rate for those serving cities and towns, � retirement status and employment in the education, health care, or the hospitality industry for those serving cities and towns.
C. Survey Distribution and Efforts to Increase Response Rate
An initial contact was made with a staff member in every city council/county board of supervisor office to verify the names of the policy makers and to identify an individual to shepherd the survey to and from the policy makers. A gift certificate for $25 at the store of the shepherd's choice was offered as an incentive to encourage a staff member to assist with distributing and collecting the surveys. Packets with introductory letters and surveys for each policy maker and information about distributing and collecting the surveys, were sent out the shepherds. Appendix 2 contains a sample of these materials. Specific return dates were stipulated for each shepherd.
Page 4
When packets were returned they were checked for completeness. Shepherds were contacted and asked to continue to try and get surveys from policy makers who had not responded. New letters and survey forms were mailed or faxed in many cases. When the shepherds reported that they could not generate any additional surveys, the individual policy makers were called on the telephone. Some asked to have the survey sent again by mail or fax and three completed the survey on the telephone.
D. Confidentiality
Policy makers were assured that their response to the questionnaire would not be associated with their name. Because the protocol called for a staff member to distribute and collect the surveys, no identifying information was included on the survey form itself, and a blank envelope was provided in which the policy maker could place his or her completed survey. Each survey form was coded with a unique identification number so that we could identify who had and had not responded to the survey. In some cases, the policy makers returned their surveys with the unique identification number removed, making it difficult to track who had and had not responded to the survey. When possible, we matched the survey with the individual in our data base based on demographic information. For example, if the survey indicated that the respondent was a woman and there was only one woman from whom we did not have a survey identified, we assumed the survey without the identification number was that woman. When that was not possible (e.g. when there were two women for who m we did not have a survey, and only one survey returned from a woman without an identification number) we generated a new ID number for the individual. This resulted in 23 additional identification numbers in our database.
E. Data Analysis
An ACCESS data file was developed which contained the basic demographic information we had for every policy maker (e.g. gender, political party affiliation, jurisdiction (city or county), name of county, name of city or town for city or town council people, populatio n, geographic size and population density of the jurisdiction served, type of government and sales tax rate for those serving cities and towns, retirement status and field of employment for those serving cities and towns. The appropriate TEPP local project was also identified for each policy maker. A second ACCESS data file was created for the survey information. The two files were merged by unique ID number and converted to an SPSS data file. All statistical analysis was conducted using SPSS routines. Results are reported as significant at the .05 level; in this report, exact significance levels are reported, rounded to two decimal places. Statistical tests of significance used in this report include chi square, ANOVA, and Pearson correlations. Scales were constructed using Principal Component factor analysis with Eigenvalues higher than 1.0 using the Oblimin rotation method.
Page 5
III. FINDINGS
A. Background: Who Are The Arizona Local Policy Makers?
Local level tobacco control policy-making can take place in a variety of jurisdictions, and at a variety of levels. Public policy making can occur through laws that are enacted in counties, cities and towns by county supervisors and mayors and city councils. School boards, health departments, and other governmental entities can also adopt tobacco-related policies or regulations. Tobacco-related policy can also be addressed in the private sector. This study focused on public policy making at the city/town council and county board of supervisors levels. Policies made that these levels have the most far reaching impact on the community. There 590 elected mayors and city council members serving in 87 municipalities in Arizona. The number who serve in each municipality ranges from five to nine, with the vast majority of municipalities having seven. Overall, 25.4% are female and 73.9% are male; we were unable to determine gender for four individuals (.7%). With the exception of Tucson and South Tucson, Arizona cities and towns have non-partisan elections for mayor and city council members. Candidates for these offices do not run as a member of any political party. However, most of these elected officials belong to a political party. Just under half (45.1%) of mayors and council members are Republicans, 38.6% are democrats, and 8% are members of other political parties, including Independents, Greens, and Libertarians. The party affiliation is unknown for 13.6% of mayors and council members. Some of these are not registered to vote according to the ir County Clerks who handle voter registration. There are 15 counties and 55 county supervisors in Arizona. All counties elect three supervisors with the exception of Coconino, Maricopa, Navajo, Pima and Yuma, which elect five. County government is much more male dominated than is city/town government. Twenty percent of those serving at the county level are female and 80% are male. County supervisors run in partisan elections. Figure 1 shows party affiliation of local policy makers. County government is more Democratic than the city/town governments. Democrats make up 61.8% of county supervisors; 38.2% are Republicans. No other political parties are represented at the county level. Considering the cities/towns and counties together, 25.0% of the policy makers are female, 74.4% are male and the gender of .6% is unknown. Party affiliation is 44.5% Republican, 40.6% Democrat, 2.5% other parties, and 12.4% unknown. Figure 1: Party Affiliation at the City/Town and County Levels
100% 75% 50% 25% 0% City/Town Republican Democrat County Ind/Green/Liber. All Unknown
45.1% 38.2% 42.7% 13.5% 38.6% 16.5% 38.2%
2.7% 61.8%
2.7%
Page 6
Local level policy makers come from a variety of professional backgrounds. The occupation of Mayors and city/town council members is listed in the Local Government Directory. The largest proportion describe themselves as business owners (24.6%), and the ne xt largest group is retired (22.0%). Appendix 3 lists the specific job titles that were grouped into the categories shown in Figure 2. The legend for this figure lists the occupational categories in descending order. Information on the occupations of county supervisors is not available. Figure 2: Occupation Categories for City/Town Council Members
Business Retired Service Education Unknown Laborer Professionals Public Service Health Care Homemakers Hospitality Sales Clerical Farm/Ranch Arts
Most communities elect mayors and city councils every two years, to serve staggered four year terms. The exceptions to this are the communities of Carefree, Cave Creek, Globe, Jerome, Miami, Nogales, Paradise Valley, and Tombstone, all of which elect a complete council every two years. At the county level, most boards of supervisors are elected every two years in their entirety with the exception of Cochise and Maricopa, which have staggered four year terms. Table 2 in Appendix 1 shows the election schedule for each local jurisdiction in Arizona. Getting elected is a public policy maker's prime goal. No matter how strongly he or she feels about the issues, getting elected is a prerequisite to being able to address those issues and therefore is paramount in a policy maker's mind. During election time, no matter what size the jurisdiction, candidates want to meet the voters and appeal to groups of voters with whom they share interests. Campaign time is an ideal time to educate incumbent and prospective policy makers about tobacco issues because at that time they are very interested in increasing their base of support. A strong and well-organized tobacco control community can have a real impact on the composition of public policy making bodies by providing information to candidates, demonstrating a large voting block, and mobilizing tobacco-control voters to work on political campaigns.
B. Sample Description
The 269 local level policy makers who responded to the survey represent 41.7% of all policy makers in Arizona. Among mayors and city council members the response rate was 41.9%. Surveys were received from 83.9% of the cities and towns. Every county was represented at the city/town level. Cities and towns not represented in the sample include: Bullhead City, Clifton, Colorado City, Douglas, Eloy, Fredonia, Huachuca City, Mammoth, Page, Pima, Prescott, Superior, Surprise, Tolleson, and Williams. Page 7
Surveys were received from 38.2% of the county supervisors, representing 66.7% of the counties. County boards of supervisors that are not represented in the sample include: Cochise, Graham, Greenlee, Pima and Navajo. Figures 3-5 compare the sample with the demographic information we have for all local level policy makers. We found no significant difference in gender, political party affiliation, or jurisdiction. In cities and towns, there was no difference in the form of government represented. Figure 3: Gender Comparison: All Policy Makers vs. Survey Respondents: Statistically equivalent
80% Percent 60% 40% 20% 0% Male Female Unknown 25% 28% 1% 1% 74% 71%
All Policy Makers
Survey Respondents
Figure 4: Party Affiliation Comparison: All Policy Makers vs. Survey Respondents: Statistically equivalent
50% 45% 43% 41% 38% 17%
Percent
40% 30% 20% 10% 0%
14% 3 % 3% Republican Democrat All Policy Makers Other
Unknown
Survey Respondents
Figure 5: Jurisdiction Representation Comparison: Statistically equivalent
100% 75% 50% 25% 0% Cities/Towns All Policy Makers Counties Survey Respondents 8.5% 7.8% 91.5% 92.2%
Page 8
The average age of the 269 survey respondents was 55.6 years (ranging from 26 to 80) and the average number of years in public office was 5.3 (ranging from 1-32). Those who serve at the county level have been in office significantly longer than those serving at the city/town level (f=32.535, p=.000) Figure 6 compares the number of years in public office for city/town and county policy makers. Figure 6: Average Number of Years in Public Office, By Jurisdiction
12 Number of Years 10 8 6 4 2 0 City County Total 4.8 5.3 11.1
With regard to tobacco use, 10.4% of the policy makers (n=27) responding to the survey report that they currently smoke tobacco. Of these, 48.1% are regular smokers , 40.7% smoke occasionally, and 9% are currently trying to quit. An additional 37.3% are former smokers (n=97), and 52.3% have never smoked (n=136). Only 2.7% prefer to sit in the smoking section of a restaurant; 85.3% prefer non-smoking and 12.0% have no preference. Almost half of all respondents (49.8%) report that they have someone close to them who has been ill or died due to a tobacco-related illness. Approximately equal proportions of males and females are currently smokers (10.2% of males, 11.0% of females), but females are more likely to have never smoked than males (chi square=8.629 p=.013). Figure 7 compares the percentage of males and females in each tobacco use category. Quitters are significantly older (60.6 years) than smokers (52.9 years) or never smokers (52.2 years) (f=17.511 p=.000). Figure 7: Smoking Status by Gender
100% 75% 50% 25% 0% Never smoked Quitter Males Females Smoker 65.8% 47.3% 42.5% 23.3% 10.2%1.0% 1
Page 9
C. Perceived locus of responsibility for public health and tobacco control
We asked the policy makers to indicate where they believe the responsibility for creating public health policy lies for a series of issues including: a. Protecting public health b. Limiting exposure to health risks in public places c. Guaranteeing clean indoor air in public places d. Guaranteeing clean indoor air in private workplaces e. Limiting the availability of tobacco to youth f. Controlling local advertising of tobacco products in retail settings, and g. Imposing local taxes, licensing, or zoning restrictions on businesses that sell tobacco products. Policy makers were asked to indicate if they believe the responsibility lies with the federal, state, county or city governments, by citizen initiative, or if they believe the issue is not an appropriate public policy issue for each policy area. We assessed the perception of the overall role of each level of government in creating public policy about the seven issues by summing the number of issues for which each policy maker identified each level of government as appropriate. We found that policy makers believe the responsibility lies with state and city government for more issues than any other level of government, and citizen initiative was considered appropriate for the least number of issues. Figure 8 shows that citizen initiative was seen as the appropriate level for creating public policy for an average of 3.8 of the seven issues, while the state and city were seen as appropriate for an average of 4.8 issues. Figure 8: Average Number of policy issues for which each level of government is perceived as having responsibility
7 6 5 4 3 2 1 0
4.2
4.8
4.5
4.8 3.8
Federal
State
County
City
Citizens
Preference for the state and city as the locus for creating public policy on the seven issues is also demo nstrated in Figure 9, which shows that 20.2% of local level policy makers saw a role for the city in every one of the seven issues, and 18.4% saw a role for the state in every issue. Citizen initiative was the level of government perceived to be least appropriate for creating public health policy. Only 8.2% saw this level of government as appropriate for addressing every one of the seven issues, and 42.7% saw it as appropriate for none of them. Although every county has a county health department, more than one in five (22.5%) of the respondents indicated they do not see a county responsibility for any of the issues, while only 15.0% indicated the county level of government as appropriate for all of the issues.
Page 10
Figure 9: Perceptions of the locus of responsibility for seven public health issues.
100% 75% 50% 25% 0% Federal State No Role County City Citizens Role in All Issues
1 13.5% 1.6% 12.7% 8.4% 1 22.5% 20.2% 15.0% 11.6% 42.7% 8.2%
The local policy makers see different roles for the various levels of government in creating public health policy for each of the seven issues we addressed (see Figure 9). While the majority of policy makers see protecting public health as a responsibility of all levels of government, when asked about more specific policies, different levels of government intervention are favored. For example, the federal government is most likely to be seen as the appropriate level of government for limiting the availability of tobacco to youth; the state is most frequently seen as the level of government that should be responsible for limiting exposure to health risks in public places, guaranteeing clean indoor air in public places, and limiting the availability of tobacco to youth. The city is likely to be seen as having responsibility for all of the issues. Although a majority of policy makers does not see a role for any one level of government in guaranteeing clean indoor air in private workplaces, those that do tend to locate the responsibility with the state and the city.
Page 11
Figure 9: Percent assigning policy responsibility to each level of government, by issue
100% 75% 50% 25% 0% a. b. Federal c. State d. County e. City f. g. a. b. c. d. e. f. Protecting public health Limiting exposure to health risks in public places Guaranteeing clean indoor air in public places Guaranteeing clean indoor air in private workplaces Limiting the availability of tobacco to youth Controlling local advertising of tobacco products in retail settings Imposing local taxes, licensing, or zoning restrictions on businesses that sell tobacco products.
Citizen
g.
a. b. c. d. e. f. g.
Federal State County City Citizen 74.5% 73.4% 67.0% 65.5% 43.1% 58.8% 70.4% 60.3% 70.8% 33.3% 49.1% 64.8% 58.4% 73.0% 30.3% 34.5% 46.1% 36.7% 45.3% 28.5% 69.8% 69.3% 56.6% 62.9% 36.3% 49.8% 52.1% 33.0% 41.9% 27.7% 23.6% 41.2% 36.0% 61.0% 16.1%
Page 12
D. The Salience of Tobacco Control
Local level policy makers deal with many issues, ranging from budgets to education, to maintenance of roads and sewers, to public safety and health. Even within the realm of public health, tobacco control is only one of many issues that demand the attention of policy makers. With so many issues to be considered, priorities are made. Raising the salience of an issue will increase the probability that it will be considered. In order to measure the salience of tobacco issues, we asked policy makers to rate the seriousness of a series of public health issues in their district on a scale of 1-10, where 1 means not serious and 10 means very serious, one of which was "tobacco use." The other issues chosen had been mentioned in the open-ended interviews with policy makers as things that they commonly deal with in the realm of public health. Figure 10 shows the average salience of each issue. Tobacco use scored relatively highly in terms of public health issue salience, exceeded only by drunk driving and access to health care. Figure 10: Average salience of public health issues
10 Seriousness 8 6 4 2 0 a b c d e f g 6.4 6.1 6.0 5.3 a. b. c. d. e. f. g. Drunk driving Access to health care Tobacco use Air quality Water quality Immunization Hazardous waste
5.1
4.9
4.6
Figures 11-14 show significant differences related to salience. The salience of tobacco use is significantly higher among female policy makers than among men (f=8.829, p=.003), higher among those who have had someone close to them be ill or die due to a tobacco related illness (f=4.527 p=.034) and higher among Democrats than among Republicans (f=3.301, p=.039). The largest significant difference in salience was between those who prefer the smoking section of a restaurant or who have no preference in restaurant seating, versus those who prefer the nonsmoking section (f=9.758, p=.000). Salience was also significantly related to popula tion density, being more salient in higher density jurisdictions Figure 11: Salience of Tobacco Use by Restaurant Seating Preference
10
Figure 12: Salience of tobacco use by gender
10
Seriousness
Seriousness
8 6 4 2 0 Smoking No Preference 4.17 4.29
6.33
8 6 4 2 0 Male 5.7
6.8
Non-smoking
Fema e Page l13
Figure13: Salience of tobacco use by political party affiliation
10
Figure 14: Salience of tobacco use by having had someone close be ill or die due to a tobacco related disease
6.6
Seriousness
8 6 4 2 0 Republican 5.6
6.0
9
Seriousness
7 5 3 1
5.6
6.3
Other
Democrat
No
Yes
E. Knowledge and Attitudes about Tobacco and Tobacco Policy
Knowledge and attitudes about tobacco and tobacco policies were measured by five statements for which policy makers were asked to indicate the degree to which they agree on a scale of 1-4 where 1 means strongly disagree and 4 means strongly agree. The statements and the average response are indicated below:
Strongly Disagree Strongly Agree
1
2
3
4 ^3.4
a. Secondhand smoke creates a serious health risk for non-smokers decisions about public tobacco policies b. The little bit of smoke you inhale in public places where smoking is permitted is not enough to hurt you c. Smokers have a right to smoke wherever they want d. The majority of Americans support strong tobacco control policies e. The majority of my constituents support strong tobacco control policies
^1.9 ^1.4 ^2.9 ^2.8
Page 14
Gender was significantly related to agreement that secondhand smoke creates a serious health risk for non-smokers (see Figure 15). Among females, the average level of agreement was 3.7, while among males it was 3.4 (f=7.301, p=.007). Figure 15: Secondhand smoke creates a serious health risk for non-smokers: by gender
4 3 2 1 0 Males Females 3.4 3.7
Knowledge and attitudes about tobacco and tobacco policy are strongly related to the perceived salience of tobacco use as a public policy issue. For example, the more strongly a policy maker agrees that secondhand smoke creates a serious health risk for non-smokers, the more serious a proble m he or she believes tobacco use is in his or her district. Alternatively, the more strongly a policy maker agrees that smokers have a right to smoke wherever they want, or that the little bit of smoke you inhale in public places where smoking is permitted is not enough to hurt you, the less serious he or she believes tobacco use to be. Table 1 summarizes the statistical relationships between salience and the knowledge and attitude items. Table 1: Correlation with perceived seriousness of tobacco use in your district Secondhand smoke creates a serious health risk for non-smokers r=.407 p=.000 The little bit of smoke you inhale in public areas where smoking is permitted is not enough to hurt you Smokers have a right to smoke wherever they want The majority of Americans support strong tobacco control policies The majority of my constituents support strong tobacco control policies r=-.319 r=-.172 r=.137 r=.147 p=.000 p=.007 p=.031 p=.022
Disagree ---- Agree
Page 15
Policy makers' knowledge and attitudes about tobacco and tobacco policy are also strongly related to their personal choices about exposure to secondhand smoke, as shown in Figure 16.. Figure 16: Knowledge and attitudes about tobacco and tobacco control by personal choice about exposure to secondhand smoke
Disagree ----- Agree 4 3 2 1 0 a Smoking section b c d e c. d. e.
2.0 3.7 2.2 2.7 2.4 1.8 2.3 2.1 1.8 3.0 2.9 2.6 2.5 2.5 2.3
a. b.
No preference
Non-smoking section
Secondhand smoke creates a serious health risk for nonsmokers (f=86.478 p=.000) The little bit of smoke you inhale in public areas where smoking is permitted is not enough to hurt you (f=14.012 p=.000) Smokers have a right to smoke wherever they want (f=24.447 p=.000) The majority of Americans support strong tobacco control policies. (f=7.389 p=.001) The majority of my constituents support strong tobacco control policies. (f=6.962 p=.001)
Page 16
F. Who Do You Trust?
While policy makers at the state and federal level are strongly and overtly influenced by campaign contributions and the special interest groups that make them, these influences are not exerted as directly at the local level. Special interests operate through local community structures to influence tobacco policy. For example, the tobacco industry enlists business groups to fight tobacco control proposals, while efforts to create tobacco control policy are supported by public health organizations. We were interested in the degree to which the opinions of specific interest groups influence local level policy makers when considering tobacco issues. We asked policy makers to rate the degree of influence each of the following sources of information have on their thinking about tobacco issues: national medial experts, health professionals in hour community, county health department staff, the American Cancer Society, the American Lung Association, business groups such as the Chamber of Commerce and local restaurant association, individual business owners, citizen anti-tobacco groups, citizen protobacco groups, youth, and the local tobacco education and prevention project. Figure 17 shows the responses to this series of questions. Ove rall trust is highest for medical sources � more than half of the policy makers state that they are strongly influenced by the opinions of national experts and local medical professionals. Just under half report they are strongly influenced by the voluntary organizations (Cancer and Lung). Policy makers trust local health programs, such as the health department and the local tobacco project somewhat less � less than a third report that they are strongly influenced by these. The opinions of youth are valued as much as the opinions of local health programs are valued. Under 10% report that they are strongly influenced by citizen anti-tobacco groups and business interests, and only 4% report that they are strongly influenced by pro-tobacco citizen groups. Figure 17: Degree of Influence of Various Sources
100% 75% 50% 25% 0% a b c Strong d e f g Little h i None j k a. b. c. d. e. f. g. h. i. j. k. National medical experts Health professionals in your community American Cancer Society American Lung Association County health department staff Local tobacco education and prevention project Youth Citizen anti-tobacco groups Individual business owners Business groups Citizen pro-tobacco groups
Moderate
A factor analysis confirmed that there are three basic dimensions of influence on policy makers' thinking about tobacco issues. They are (1) Medical/health interest groups: National medical experts Health professionals in your community American Cancer Society American Lung Association County health department staff Page 17
(2) Business interest groups:
Business groups (Chamber of Commerce, Restaurant Association) Individual business owners Citizen anti-tobacco groups Citizen pro-tobacco groups Youth Local tobacco projects
(3) Citizen interest groups:
It is notable that local tobacco projects are not part of the medical/health interest group cluster, but as part of the citizen interest group cluster. This suggests that local tobacco project staff is not perceived as health experts but as part of the grassroots community. We created indexes of influence of medical/health, business, and citizen group sources by calculating the average degree of influence for the items in each category. On a scale of 1-4, where 1 means no influence and 4 means strong influence, the average scores on the influence indexes were:
No influence Strong influence
1 Medical/health interest group influence Citizen interest group influence Business interest group influence
2
3
4
^3.28 ^2.54
^2.32
Scores on the three indexes were significantly correlated � the higher the score on medical/health group influence, the higher the score on business group and citizen group influence. This suggests that policy makers are influenced by medical and health interest groups the most, but the more they are influenced by them, the more they are also influenced by other groups. Testing for differences in the influence of the three sources of influence we found that female policy makers are significantly more likely to trust medical sources than are males (f=7.171, p=.008). Population density of the jurisdiction was also significantly related to the influence of medical/health interests (p=.006) and citizen interests (p=.005), but not to business interests. These groups have more influence in more densely populated communities than in less densely populated ones. No differences were found in comparing policy makers by their political party affiliation, by jurisdiction or by form of government. Age was significantly related to the influence of business and citizen groups. The older the policy maker, the less they trust both business (p=.007) and citizen (p=.000) interest groups. Number of years in office, however, was not related to influence by these groups (although older policy makers were found to have held office significantly longer). This suggests that mistrust of the opinions of business and citizen groups is not a function of time in office, but only of age.
G. What types of information are preferred by local level policy makers?
Policy makers at every level must make decisions about important and very complicated issues that will have an impact on the communities that they serve. While each policy maker brings his or her own expertise to the policy debate, it is not possible for any policy maker to have expertise Page 18
about every issue that is considered. The questionnaire asked about preferences for some specific information resources that are commonly used by policy makers, and asked the policy makers to rate various information types, formats and sources in terms of their decision making process. We asked how much the following types of information would influence policy maker decisions on local tobacco policy issues: scientific information about health effects, business/economic concerns, letters and phone calls from community members, newspaper editorial board positions, letters to the editor, fellow board- member positions, and personal experience. Respondents could rate each of the seven types on a scale of 1-4, where 1 meant no influence and 4 meant strong influence. Scientific information and their own personal experience are rated higher than any other types (see Figure 18).
Figure 18: Influence of information types on local policy maker decisions about tobacco policy
100% 75% 50% 25% 0% a b Strong c d e Little f None g a. b. c. d. e. f. g. Scientific information about health effects Personal experience Letters and phone calls from community members Business/economic concerns Fellow board-member positions on the issue Newspaper editorial board positions Letters to the editor
Moderate
H. What resources do policy makers have for gathering and interpreting information?
Having to deal with a very broad range of issues, policy makers cannot be experts in all of them. They must rely on others to provide background and information about many of the issues they must consider. The resources they have for gathering information may determine the position they take on an issue. We looked closely at two types of resources that policy makers might use to learn about tobacco issues � staff members who can gather and synthesize information for the policy maker, and the internet. Staff Most local level policy makers (62.4%) always have staff support for gathering information about policy issues they are considering. Another 19.8% report that they freque ntly have staff support, 11.6% sometimes have support, and 6.2% never have staff support. Those serving at the Page 19
city/town level were more likely to have staff support if they served in a council/manager form of government.(Chi square =7.948 p=.047). There was no relationship between staff status and whether the jurisdiction was a city/town or county, the population or population density of the jurisdiction served, or personal characteristics of the policy maker, such as age, gender, or years in office. Figures 19 and 20: Cities/Towns: Do you have staff support to gather information about policy issues being considered by the council/board? By type of Government
Council/Manager
Other Form of Government
Never Sometimes Frequently Always
Never Sometimes Frequently Always
I. Internet Capacity Another resource that can be used to gather information about policy issues is the internet. More than three quarters (76.7%) of the policy makers reported that they have personal access to the internet. There were no gender differences regarding personal access to the internet. However, age was significantly rela ted to personal internet access; the average age of those with personal access to the web was 53.6 years, while the average age of those without personal internet access was 61.8 years (f=23.655 p=.000). Less than a third (29.0%) of policy makers report that their staff frequently uses the internet to look for information about public policy topics being considered; 40.6% report that their staff uses it sometimes, 17.0% occasionally use it, and 13.4% never use it. Among those serving at the city/town le vel, the type of government is significantly related to personal internet access and to staff use of the internet (see Figure 21). City/town policy makers serving in a council/manager form of government were significantly more likely to have personal access to the web than are those that serve in some other type of government (Chi square=20.695 p=.000). Almost three quarters (72.0%) of policy makers' staff serving in council/city manager governments use the internet to look for information, compared to 42.9% of those who serve in types of city/town government. (chi square=10.367 p=.016). Figure 21: City/Town Personal Internet Access by Type of Government
100% 75% 50% 25% 0% Council/Manager Staff use Other govt. Personal Access 72.0% 81.2% 49.2% 43.3%
Page 20
The degree of internet capacity varies greatly by local project area. Table 2 shows the percentage of responding local policy makers who report having personal internet access by Local Project. Table 2: Personal Internet Access by Local Project Area Local Project Number % with reporting access Apache 9 66.7% Cochise 17 82.4% Coconino 8 75.0% Gila 18 66.7% Graham 5 100.0% Greenlee 5 40.0% LaPaz 8 75.0% Maricopa: Mesa 4 100.0% Maricopa: Northern 10 70.0% Maricopa: Scottsdale 6 100.0% Maricopa: SouthCentral 6 100.0% Maricopa: Southeast Valley 14 100.0% Maricopa: TAG/TUP 7 71.4% Maricopa: TLC 12 66.7% Maricopa:Western 24 79.2% Mohave 4 25.0% Navajo 24 83.3% Pima 13 92.3% Pinal 16 56.3% Santa Cruz 8 50.0% Yavapai 21 81.0% Yuma 12 75.0% Total 252 76.7% Reported Use of the Internet While more than three quarters of local policy makers have access to the internet, only 54.1% of those use it regularly, 30.4% use it sometimes and 15.5% have never used it or have only tried it. Having personal internet access is strongly related to using it (chi square=161.321 p=.000), and to using it specifically to look for information about a current public policy topic (chi square=93.242, p=.000). Those with personal internet access are also more likely to use information from the web it if were made available to them (chi square=35.801 p=.000).
Page 21
Figure 22: How likely are you to use information on the internet when you consider a public policy health issue?: Comparison of those with and without personal internet access
100% 80% Percent 60% 40% 20% 0% Would use Have internet access Would not use 53% 15% 47% 85%
Do not have internet access
Whether or not a policy maker would use information from the internet is strongly related to the degree of trust he or she has in that information source. Overall, only 28.1% say they strongly trust information from the internet. The majority (64.1%) say they trust internet information somewhat and 7.8% do not trust it at all.
Use of the internet in general, is significantly related to age (see Figure 23). The older the policy maker, the less likely he or she is to use the internet (f=11.712 p=.000). Figure23: How frequently do you use the internet? By Age
70 Age in Years 60 50 40 1 2 3 4 Never --- Regularly
62.4 57.5 52.3 52.2
County supervisors are significantly more likely to report that they frequently or sometimes use the internet than are policy makers serving at the city/town level. This finding is independent of age. That is, we tested to see if county supervisors happen to be younger that those serving at the city/town level, but there was no significant age difference between the two groups. Sixty- five percent of county level policy makers use the internet frequently or sometimes, while only 41% of city/town level policy makers do so. Page 22
I. How do local policy makers prefer to hear from their constituents?
We asked policy makers the degree to which they prefer various types of contact from constituents (including letters, e- mail, faxes, telephone calls to the council office, telephone calls to the home, telephone calls to the place of business, face to face meetings, inviting the policy maker to events or meeting with the policy maker's staff). Preferences for constituent contact varied considerably among policy makers. The most preferred method of contact was by letter: 89.9% of all policy makers prefer to be contacted by letter. Setting up a meeting was preferred by 64.1%, fax contact was preferred by 63.5% and e- mail contact was preferred by 62.9%. No other type of contact was preferred by more than half of the policy makers. Figure 24 shows the level of preference for each type of contact: Figure 24: Constituent Contact Preferences
100% 75% 50% 25% 0% a b
4 a. b. c. d. e. f. g. h. i. Write a letter Send an e-mail Schedule an appointment for a meeting Send a fax Meet with my staff Telephone call to the council office Telephone call to my home Invite me to an event Telephone call to my place of business
c
d
3
e
2
f
g
1
h
i
Strongly prefer -----------------Do not prefer
Factor analysis of the preferred contact items showed that overall, responses clustered into three categories: (1) Face-to-Face contact: Schedule an appointment for a meeting Invite me to an event Meet with my staff Send an e- mail Send a fax Telephone call to the council office Telephone call to my home Telephone call to my place of business
(2) Formal contact
(3) Informal contact
On a scale of 1-4, where 1 means "do not prefer" and 4 means "strongly prefer," policy makers most prefer either formal (mean=2.5) or face-to-face (mean=2.5) contact, over informal (mean=1.8) contact (see Figure 25). Female policy makers were significantly more likely to prefer informal (f=8.932 p=.003) and face-to- face (f=4.297 p=.039) contact than were male policy makers. Page 23
Figure 25: Constituent Contact Preference Scales
4 3 2 1 0 Formal Face-to-face Informal 2.5 2.5 1.8
Writing a letter was not clearly identified with any of the three factors, but was a component of all three. This analysis suggests that most policy makers prefer formal contact (e- mails, faxes, and telephone calls to the council or supervisor offices), the most policy makers, but particularly women prefer face-to-face contact, and that informal contact is not recommended unless you know specifically that a particular policy maker prefers it. Those that do prefer it are more likely to be women. No matter what the strategy for contacting policy makers is, letter writing should be part of it. In addition to asking about their preferred methods of constituent contact, we also asked about the format in which local level policy makers prefer to receive information. Figure 26 shows that detailed reports , brief fact sheets and technical studies are the most preferred. Video presentations, internet based information and annotated bibliographies are less likely to be used. Figure 26: Preferred information formats
100% 75% 50% 25% 0% a b 4 c 32 d 1 e f a. b. c. d. e. f. Detailed reports Brief one page fact sheets, pamphlets or brochures Copies of technical/scientific studies Video tapes presentations Information on the internet Annotated bibliographies
Definitely would use --- Definitely would not use
Page 24
IV. CONCLUSION
Successful policy advocacy depends on building strong, trusting, and lasting relationships with local level policy makers. The findings of this study suggest specific actions local tobacco projects and their coalitions can take to accomplish this in the policy arena. For example, this study found that most policy makers trust medical sources more than citizen groups or business interests when considering health and tobacco policy issues, and that Arizona's local tobacco projects are currently viewed as "citizen groups." That perception should be changed in order to increase the level of trust local policy makers have in the local tobacco projects. Coalitions should include recognized medical and health care experts from the community and these individuals should take a leading role in communicating with policy makers and advocating for specific policy changes. While the relationship between the coalition and the project should be highlighted, these efforts should also be coordinated with other health advocacy groups in the community. Local project staff members, who are prohibited from direct lobbying activities, should establish a relationship with local policy makers by providing them with medical and scientific information on tobacco issues on an ongoing basis. Supplying published articles along with a brief summary of the findings would be a welcome approach. The majority of local policy makers do recognize a role for local government in protecting public health, limiting exposure to health risks in public places, guaranteeing clean indoor air in public places, and limiting the availability of tobacco to youth. These issues are likely to be better received by policy makers than issues such as guaranteeing clean indoor air in private workplaces, and controlling local tobacco advertising in retail settings, which are not viewed by the majority as appropriate for local government intervention. Most local policy makers are aware of ETS as a health hazard, but they minimize the effect of secondhand smoke in public places, and therefore do not necessarily support clean indoor air policies. They also underestimate public support for strong tobacco control policies. Education on these issues is needed. Finally, while public health and selected tobacco issues are viewed by local level policy makers as being within the purview of local government, our data suggest that public health issues, including tobacco control, are not seen as being particularly salient by local level policy makers. Salience is related to knowledge, however, and education of policy makers may serve to increase the salience of tobacco issues in their otherwise full agendas. Salience is also related to perceptions of constituent support for strong tobacco control policies. These findings support an approach where local project staff provide timely scientific information and coalitions demonstrate broad community support in order to raise the salience of tobacco issues among local level policy makers, while medical experts are prominent among those enlisted to address health issues related to specific policy proposals.
Page 25
Appendix 1 Structured, Open-ended Interview Outline Policy Maker Interviews:
� � � � � �
U of A study of local level policy makers. Interested in how policy makers access information about health-related topics and how community interest groups influence their decis ions. Focus of the interview is around tobacco issues. We are interviewing all of the city council/county supervisors in three communities � Mesa, Lake Havasu, and Yuma in order to gain an understanding of the issues. The information will be used to frame the questions we will ask in a brief telephone survey of all city council/county supervisors in Arizona Confidential, no names
1. How long have you served? 2. Has the council/supervisors considered any tobacco issues since you were elected? � What were the issues? � Who brought it before the council? � Who or what organizations were involved in the discussion? � What arguments were made on both sides? � What argument do you think was the most persuasive? Why? � What argument most influenced the outcome of the vote? Why? 3. What role do you think local government should play in: � protecting public health � limiting youth access to tobacco, � creating smoking bans in public places including restaurants, � restricting sales and advertising 4. What is the most effective way for someone with an interest in an issue like tobacco policy to contact you? What kind of information is most meaningful to you? What format do you prefer when someone provides you with information? � phone, mail, e-mail, meeting, talk to aide � reading material, web sites, data 5. How much do you trust the information provided by: What do you think their biases are? � The medical community (e.g. doctors and organizations like the Cancer Society, Lung Association, Heart Association etc.) � The public health community (e.g. city/county health department) � The business community (restaurant association, chamber of commerce, large and small business owners) � Individual concerned citizens � Youth � Any other players identified by the interviewee 6. Who do you see as the "experts" on tobacco issues when it comes to public policy decisions? Page 26
7. How much of an influence on your opinion are... � Editorials � Scientific studies � Studies conducted locally � Health professionals � Tobacco industry � Health department officials � Your colleagues � Family and friends � Constituents � Your intuition 8. Are you familiar with the Local Project? � Mohave County Tobacco Prevention Program (McTUPP) (Susan Williams) � Mesa Partnership for Tobacco-Free Youth and Community (Johnna Switzer) � The tobacco program at the Yuma County Department of Public Health (Donna Miller) � What kinds of things does this program do in your community? � Have you ever participated in any activities sponsored by the Local Project? Which ones, in what capacity? � Do you personally know anyone who is a member of the local tobacco coalition? � Have you had any other kind of contact with the Local Project � describe... 9. Personal Information � Gender, � Party � Age � Have kids at home? � What organizations, both professional and recreational do you belong to? � Have you ever used tobacco? Do you use tobacco now?
Page 27
Appendix 2 The following questions address how you receive and use information on public policy issues. Please circle or check your responses. 1. Do you have staff support to gather information about policy issues being considered by the council/board? _____ Always
4
_____ Frequently
3
_____ Sometimes
2
_____ Never
1
2. If a constituent wanted to contact you about a tobacco policy issue, what would you prefer he or she do? Do Not Prefer
a. Write a letter b. Send an e-mail c. Send a fax d. Telephone call to the council office e. Telephone call to my home f. Telephone call to my place of business g. Schedule an appointment for a meeting h. Invite me to an event i. Meet with my staff j. Other (Please specify: _______________________________ __________________________________________________) 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3
Strongly Prefer
4 4 4 4 4 4 4 4 4 4
3. How much would the following types of information influence your decisions on local tobacco policy issues?
S
trong
Influence 1 1 1 1 1 1 1 2 2 2 2 2 2 2
No
3 3 3 3 3 3 3
a. Scientific information about health effects b. Business/economic concerns c. Letters and phone calls from community members d. Newspaper editorial board positions e. Letters to the editor f. Fellow board-member positions on the issue g. Personal experience
Influence 4 4 4 4 4 4 4
Page 28
h. Other (Please specify: _______________________________ ___________________________________ _______________)
1
2
3
4
4. How much influence would the opinions of each of the following sources of information have on your thinking about tobacco issues in your locality?
a. National medical experts b. Health professionals in your community c. County Health Department Staff d. The American Cancer Society e. The American Lung Association f. Business groups (Chamber of Commerce, Restaurant Assoc) g. Individual business owners h. Citizen anti-tobacco groups i. Citizen pro-tobacco groups j. Youth k. The local tobacco education and prevention project
No Influence 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3
Strong Influence 4 4 4 4 4 4 4 4 4 4 4
5. How likely are you to use the following information formats when you consider a public policy health issue?
Definitely not use 1 1 1 1 1 1 Definitely would use 4 4 4 4 4 4
a. Detailed reports b. Copies of technical/scientific studies c. Annotated bibliographie s d. Brief one page Fact Sheets, pamphlets or brochures e. Video taped presentations f. Information on the internet (web)
2 2 2 2 2 2
3 3 3 3 3 3
Page 29
6. Are there any other information formats you rely on when considering a public policy health issue? _____ No
0
____ Yes (Please specify:
1
)
The following questions are about e-mail and the internet/worldwide web. Please check your responses. Please check your responses. 7. Do you have personal access to: a. e-mail?
______ No
0 0
______Yes
1
b. the internet (worldwide web)? ______ No 8. How frequently do you use: a. e-mail ? b. the internet? ________
regularly 4 regularly 4
______Yes
1
sometimes3 sometimes3
________ ________
tried it 2 tried it 2
________
never1 never1
________
________ ________
________
9. How comfortable are you seeking information on the internet (worldwide web)?
_____ Very 4 Comfortable _____ Somewhat 3 Comfortable _____ Not comfortable 2 but anxious to learn _____ Not comfortable 1 and probably won't use it
10. Do you ever use the internet (worldwide web) to look for information about a public policy topic you are considering?
_____ Frequently
4
_____ Sometimes
3
_____
2
Occasionally
_____ Never
1
11. Does your staff ever use the internet (worldwide web) to look for information for you on a policy topic you are considering?
_____ Frequently
4
_____ Sometimes
3
_____
2
Occasionally
_____ Never
1
12. How much would you trust information about public policy topics that comes from the internet?
_____ Totally
4
_____ A great deal
3
_____
2
Somewhat
_____ Not at all
1
Page 30
The following questions are about your opinions. 13. How much do you agree or disagree with the following statements? (circle your response)
Strongly Disagree Strongly Agree
a. Secondhand smoke creates a serious health risk for non-smokers b. Health issues should take precedence over business concerns in making decisions about public tobacco policies III. c. The little bit of smoke you inhale in public areas where smoking is permitted is not enough to hurt you. d. Smokers have a right to smoke wherever they want. e. If it is clear that my constituents do not want it, I will not vote for something even if I think is right. f. The majority of Americans support strong tobacco control policies. g. The majority of my constituents support strong tobacco control policies.
1 1 1 1 1 1 1
2 2 2 2 2 2 2
3 3 3 3 3 3 3
4 4 4 4 4 4 4
14. Who do you believe has the responsibility for creating public policy for each of the following issues? Please circle all that apply.
Federal government a. Protecting public health b. Limiting exposure to health risks in public places. c. Guaranteeing clean indoor air in public places. d. Guaranteeing clean indoor air in private workplaces e. Limiting the availability of tobacco to youth f. Controlling local advertising of tobacco products in retail settings g. Imposing local taxes, licensing, or zoning restrictions on businesses that sell tobacco products 1 1 1 1 1 1 State government 2 2 2 2 2 2 County government 3 3 3 3 3 3 City government 4 4 4 4 4 4 Citizen initiative 5 5 5 5 5 5 Not an appropriate public policy issue 6 6 6 6 6 6
1
2
3
4
5
6
15. On a scale of 1-10, where 1 means not serious and 10 means very serious, how serious are problem are the following health issues in your district? a. Access to health care _____ e. Hazardous waste _____ b. Water quality _____ f. Drunk driving _____ c. Tobacco use _____ g. Immunizations _____ Page 31 d. Air quality _____
The last questions are about personal information. Remember this survey is confidential-- all of the findings will be reported only in the aggregate. Please fill in or check the answers that describe you:
16. Age : _____________ 17. Gender: _____ Male
0
18. Number of Years in Office: _______ years
_____Female
1
19. Tobacco use status: ___ Current regular 1 smoker
___ Current occasional
2
smoker
___ Current smoker
3
trying to quit
0
___ Former
4
Smoker
1
___ Never
5
Smoked
20. Has someone close to you been ill or died due to a tobacco-related illness? _____No 21. When you go to a restaurant, where do you prefer to sit? _____ smoking section
1
_____Yes
_____ non-smoking section
2
_____ no preference
3
Thank you!
Page 32
APPENDIX 3 CLASSIFICATION OF OCCUPATIONS OF MUNICIPAL ELECTED OFFICIALS
CATEGORY Arts Business Occupations Artist Potter Advertising executive Broker marketer Building contractor Business owner Businessman/woman Car dealer CEO Contractor Distributor Insurance agent/sales Investments Publishing Real estate broker Real estate developer Real estate/realtor Self employed Title specialist Accounting clerk Bookkeeper Cashier Clerk Paralegal Secretary Administrator/faculty associate College administration College English teacher College student Director of education Educator Flight instructor Migrant Head Start Center director School aide School counselor School custodian School district School principal Student Teacher Teacher's aide University of Arizona Dairyman Farmer Page 33
Clerical
Education
Farming/Ranching
CATEGORY Health
Homemaker Hospitality
Labor
Labor (continued)
Occupations Landscape management Ranch owner Certified dental assistant Chiropractor Dentist EMT Health and safety inspector Health director Medical administrator Mt. Graham hospital Nurse manager Nurse, R.N. Oncology account manager Physician Psychologist Public and environmental health specialist Respirator room attendant V.A. Hospital Veterinarian Homemaker Housewife Food service manager Hotelier Motel owner Restaurant manager Restaurant owner Restaurateur Waitress ASARCO Ray Mine Auto technician Builder Construction Cook Diesel mechanic Electronic technician Equipment operator Field mechanic Hair stylist Instrumentation technician Laborer Machinist Maintenance technician Manufacturing Mechanic Operator SRP Paper mill Phelps Dodge Railroad engineer Page 34
CATEGORY
Professionals
Public Service
Sales
Service Service (cont)
Occupations Truck driver Utility service Welder Accountant Architect Attorney Civil engineer Consulting engineer CPA Engineer Nuclear engineer Systems engineer Adult probation specialist Civil service Councilman/woman County employee Court clerk Deputy sheriff Government employee Parks and recreation Police chief Postal employee Probation Public works Relocation Commission Director Senior citizens director Sheriff's department Antique dealer Gallery owner Market manager Retail management Retail/retailer Sales consultant Sales manager Sales representative Sales/salesman Vehicle sales Account manager Administrator Banker Business representative Clergy Client services Computer data assistant Computer systems manager Construction management Consultant Contract manager Page 35
CATEGORY
Occupations Control room operator Controller Director/Executive Director District manager Drafter Electric utilities Escrow branch manager Event producer Financial analyst Fire administrator General manager H.R. facilitator Housing America Human resource manager Interior design Loan officer Lumber store manager M.H. Park Manager Manager Manager � food store Media director MIS director Mortgage broker Operations manager Pest control Powerhouse leadman President Production manager Project coordinator Project manager Property manager Senior financial credit analyst Smelter supervisor Supervisor Utility executive
Page 36
Appendix 4: Information by Local Project Table 1: Number of Policy Makers Reporting by Local Project Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Unknown Total Number reporting 9 18 8 21 5 5 9 1 4 10 7 6 14 7 12 25 5 26 14 17 10 22 13 1 269
Page 37
Table 2: Election Cycles for Local Arizona Jurisdictions Two year terms expire Four year terms expire Municipalities Apache Junction June odd numbered years Avondale Dec. odd numbered years Benson June odd numbered years Bisbee Dec. eve n numbered years Buckeye May even numbered years Bullhead City June odd numbered years Camp Verde June odd numbered years Carefree June odd numbered years Casa Grande June odd numbered years Cave Creek June odd numbered years Chandler June even numbered years Chino Valley June odd numbered years Clarkdale June even numbered years Clifton May even numbered years Colorado City May even numbered years Coolidge June even numbered years Cottonwood May odd numbered years Douglas June even numbered years Duncan June odd numbered years Eager July even numbered years El Mirage June even numbered years Eloy June even numbered years Flagstaff June even numbered years Florence May even numbered years Fountain Hills June even numbered years Fredonia July even numbered years Gila Bend June odd numbered years Gilbert June odd numbered years Glendale June even numbered years Globe May even numbered years Goodyear June odd numbered years Guadalupe May odd numbered years Hayden June odd numbered years Holbrook May odd numbered years Huachuca City May odd numbered years Jerome June even numbered years Kearny May even numbered years Kingman June even numbered years
Table 2 (continued)
Page 38
Two year terms Lake Havasu City Litchfield Park Mammoth Marana Mesa Miami Nogales Oro Valley Page Paradise Valley Parker Patagonia Payson Peoria Phoenix Pima Pinetop-Lakeside Prescott rescott Valley Quartzite Queen Creek Safford Sahuarita St. Johns San Luis Scottsdale Sedona Show Low Sierra Vista Snowflake Somerton South Tucson Springerville Superior Surprise Taylor Tempe Thatcher Tolleson Tombstone Tucson Wellton Wickenburg
Four year terms, staggered Nov. even numbered years June even numbered years June even numbered years May odd numbered years June even numbered years
June even numbered years Dec. even numbered years May even numbered years June odd numbered years April even numbered years May odd numbered years June even numbered years May even numbered years June odd numbered years Dec. odd numbered years Dec. even numbered years May odd numbered years Nov. odd numbered years June odd numbered years June even numbered years May even numbered years May even numbered years May odd numbered years June odd numbered years June even numbered years June even numbered years June even numbered years June even numbered years June odd numbered years June odd numbered years May odd numbered years June odd numbered years June even numbered years June odd numbered years June odd numbered years May odd numbered years July even numbered years June even numbered years June odd numbered years Nov. even numbered years Dec. odd numbe red years May odd numbered years May even numbered years
Page 39
Table 2 (Continued)
Two year terms Willcox Williams Winkelman Winslow Youngtown Yuma Counties Apache Cochise Coconino Gila Graham Greenlee La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Four years staggered terms June even numbered years June even numbered years June even numbered years May even numbered years May odd numbered years Dec. odd numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years
Dec. even numbered years
Table 3: Political Party of Survey Respondents by Local Project Republican Democrat IndepenLocal Project dent Apache 0 1 0
Green 0
Libertarian 0
Not Known 8 Page 40
Cochise Coconino Gila Graham Greenlee LaPaz Maricopa Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: SE Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Unknown Total
8 1 7 0 1 3 1 1 5 7 3 8 2 7 17 5 16 6 3 1 9 4 115
7 6 13 5 4 3 0 1 0 0 1 1 4 4 5 0 10 5 11 8 5 8 102
0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 5
0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
3 0 0 0 0 3 0 2 5 0 2 5 1 1 1 0 0 3 2 1 7 0 1 45
Table 4: Tobacco Use Status of Survey Respondents Local Project Current Current Regular occasional Smoker Smoker Apache Cochise 0 0 0 0
Current smoker, trying to quit 0 0
Former Smoker 3 10
Never Smoked 6 5 Page 41
Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
1 5 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 2 0 2 0 13
0 1 0 2 1 0 0 0 1 0 0 0 0 0 1 0 2 0 0 2 1 11
0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 3
1 5 2 0 3 1 1 5 3 2 2 2 5 9 2 11 6 8 4 9 3 97
6 10 3 3 3 0 3 5 2 3 12 5 6 14 2 13 6 7 5 7 9 135
Table 5: Restaurant Seating Preference of Survey Respondents Local Project Smoking Non Smoking No Preference Apache 0 8 1 Cochise 0 14 2 Coconino 0 7 1 Gila 2 15 4 Graham 0 5 0 Greenlee 1 2 2 LaPaz 1 5 2 Maricopa (countywide) 0 1 0 Maricopa: Mesa 0 4 0 Page 42
Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0 0 0 0 0 0 0 0 2 0 1 0 0 0 7
10 5 5 13 7 10 18 4 23 13 14 7 17 13 220
0 2 0 0 0 1 6 1 0 1 2 3 3 0 31
Table 6: How much do you agree or disagree that secondhand smoke creates a serious health risk for non-smokers?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Strongly Disagree 0 1 0 3 0 1 0 0 0 Disagree 0 3 0 4 0 1 3 0 0 Agree 1 2 3 5 1 0 1 0 0 Strongly Agree 8 11 5 8 4 3 4 1 4 Page 43
Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0 0 0 1 0 0 2 0 0 2 1 0 0 0 11
0 3 0 0 0 2 3 1 1 1 1 3 3 0 29
3 1 1 3 1 1 9 2 3 4 5 1 4 4 55
7 3 5 10 6 9 11 1 21 7 10 6 14 9 167
Table7: How much do you agree or disagree that the little bit of smoke you inhale in public places where smoking is permitted is not enough to hurt you?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Strongly Disagree 5 7 3 8 2 1 3 0 1 2 1 Disagree 4 5 4 3 3 2 3 1 3 3 2 Agree 0 2 1 2 0 1 2 0 0 4 3 Strongly Agree 0 3 0 7 0 1 0 0 0 1 1 Page 44
Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
2 5 5 7 8 0 13 5 11 5 8 6 108
4 3 1 3 10 2 9 2 3 4 6 5 85
0 3 0 1 6 2 2 6 1 1 5 1 43
0 2 1 1 1 0 1 1 2 0 2 1 25
Table 8: How much do you agree or disagree that smokers have a right to smoke wherever they want?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Strongly Disagree 8 14 7 12 4 1 5 4 8 3 6 11 7 9 Disagree 0 2 1 2 1 1 0 0 1 3 0 2 0 2 Agree 1 1 0 3 0 1 0 0 1 1 0 0 0 0 Strongly Agree 0 0 0 2 0 1 3 0 0 0 0 0 0 0 Page 45
Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
16 3 21 12 11 6 13 11 192
5 1 3 2 3 1 7 1 38
2 0 0 0 0 3 0 0 14
2 0 0 0 2 0 1 1 12
Table 9: How much do you agree or disagree that the majority of Americans/my constituents support tobacco control?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Strongly Disagree 0/1 0/1 0/0 2/1 1/0 1/2 0/0 0/0 0/0 0/0 0/1 0/1 0/0 0/0 0/0 0/1 0/0 Disagree 2/0 7/12 1/2 8/5 0/1 1/1 0/1 0/1 0/0 2/1 1/2 1/0 2/4 1/3 3/2 10/10 1/2 Agree 4/5 8/4 4/4 5/9 2/3 3/2 6/4 1/0 4/4 2/5 5/4 2/4 9/7 1/2 4/5 11/8 3/2 Strongly Agree 3/3 2/0 3/2 3/3 2/1 0/0 2/2 0/0 0/0 6/4 1/0 2/0 3/3 5/1 5/4 4/6 0/0 Page 46
Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0/1 0/0 1/1 1/1 0/0 0/0 6/11
7/6 3/3 5/5 3/2 5/7 1/2 64/72
11/9 8/8 8/9 3/4 11/10 10/8 125/120
7/8 3/2 3/2 3/2 3/3 2/3 62/49
Table 10: How much do you agree or disagree that health issues should take precedence over business concerns in making decisions about public tobacco policies?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Strongly Disagree 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 Disagree 0 3 0 4 1 1 0 1 0 2 3 1 1 0 0 6 1 2 Agree 4 6 2 6 3 3 2 0 3 3 2 2 7 2 2 8 2 11 Strongly Agree 5 7 6 9 1 0 5 0 1 5 2 3 5 5 10 10 1 12 Page 47
Pima Pinal Santa Cruz Yavapai Yuma Total
0 2 0 0 0 6
3 0 3 3 0 35
7 5 3 7 10 101
4 10 3 11 3 118
Table 11: Do you have staff support to gather information about policy issues being considered by the council/board? Local Project Never Sometimes Frequently Always Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave 0 2 0 4 1 2 1 0 0 2 0 0 0 1 0 2 0 3 1 1 5 2 1 2 0 0 0 0 1 0 0 2 2 1 1 2 4 4 0 1 1 1 0 1 0 0 4 2 4 5 1 5 12 3 7 2 1 5 0 4 5 7 4 8 4 5 16 3 Page 48
Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0 1 0 0 0 0 16
1 1 0 2 3 2 30
4 4 2 1 5 4 51
20 8 15 7 13 7 161
Table 12: How frequently do you use e-mail? Local Project Never Tried it Apache 2 0 Cochise 4 1 Coconino 0 1 Gila 5 2 Graham 0 0 Greenlee 3 0 LaPaz 2 0 Maricopa (countywide) 0 0 Maricopa: Mesa 0 0 Maricopa: Northern 3 1 Maricopa: Scottsdale 0 0 Maricopa: SouthCentral 0 1 Maricopa: Southeast Valley 1 1 Maricopa: TAG/TUP 3 0 Maricopa: TLC 2 1 Maricopa:Western 7 2 Mohave 3 0 Navajo 4 4 Pima 0 0 Pinal 7 1 Santa Cruz 6 1 Yavapai 3 1 Yuma 3 1 Total 58 18
Sometimes 0 5 2 5 2 1 2 1 2 2 0 0 0 0 2 0 0 5 1 1 0 4 4 39
Regularly 6 7 5 6 3 1 5 0 2 4 7 5 12 3 6 15 1 11 12 8 3 13 5 140
Page 49
Page 50

Click tabs to swap between content that is broken into logical sections.

Copyright to this resource is held by the creating agency and is provided here for educational purposes only. It may not be downloaded, reproduced or distributed in any format without written permission of the creating agency. Any attempt to circumvent the access controls placed on this file is a violation of United States and international copyright laws, and is subject to criminal prosecution.

Arizona State Library, Archives and Public Records--Law and Research Library.

Full Text

Understanding Tobacco Policy Making From Local Policy Makers' Point of View:
A study of elected Arizona policy makers at the city and county levels
Merrill Eisenberg, Ph.D. Kirsten Elliott Kristie Taylor Ron Woodard Arizona Tobacco Information Network November, 2000
Funded by the Arizona Department of Health Services, Tobacco Education and Prevention Program (TEPP)
Page 1
TABLE OF CONTENTS
I. Purpose Formative Research and Survey Development Identifying Policy Makers and Public Information Survey Distribution and Efforts to Increase Response Rate Confidentiality Data Analysis
II. Methods A. B. C. D. E.
III. Findings A. Background: Who are the Arizona Local Policy Makers? B. Sample Description C. Perceived Locus of Responsibility for Public Health and Tobacco Control D. The Salience of Tobacco Control E. Knowledge and Attitudes About Tobacco and Tobacco Policy F. Who Do You Trust? G. What Types of Information Are Preferred by Local level Policy Makers? H. What Resources Do Policy Makers Have for Gathering and Interpreting Information? I. How Do Local Policy Makers Prefer to Hear From Their Constituents? IV. Conclusion Appendix 1: Information by Local Project Appendix 2: Survey Materials Appendix 3: Classification of Occupations of Municipal Elected Officials
Page 2
I. PURPOSE
The purpose of this study is to provide information describing local level public policy makers and how they approach policy making, so that the local tobacco projects can be better prepared to work with elected officials and meet their informational needs. Specific research questions that are answered by this study include: � � � Who are the local policy makers in Arizona? A basic demographic description of the universe of policy makers is provided. A more detailed description is provided for policy makers who participated in the survey. What is the salience of tobacco use in the overall range of health issues facing local policy makers? The perceived seriousness of tobacco use as a health issue is contrasted with other health issues commonly addressed by local policy makers. What do local policy makers believe about tobacco control and the role of government in public health and tobacco control issues? A description and analysis policy makers' opinions about the role of federal, state, county, city, and citizen initiative in creating public policy for a variety of issues is presented. Opinions about tobacco control policy and the health effects of ETS are also included. Whose opinions most influence local policy makers? The influence of various information sources is described and analyzed. How do local policy makers prefer to hear from their constituents? A description and analysis of contact preferences is provided. What types of information and information formats are preferred by local level policy makers? Preferences for various information sources and formats are described and analyzed. What resources do policy makers have for gathering and interpreting information? Staff availability e- mail/internet capability are assessed. How these resources are used as tools for gathering and interpreting information is described and analyzed.
� � � �
II. METHODS
A. Formative Research and Survey Development
The study began with structured, open-ended interviews with local project directors to identify the range of experiences they have had with local level policy makers. From these interviews, three types of interactions with local policy makers were identified: no interaction, successful interaction, and unsuccessful interaction. We then identified three communities representing each type of interaction in which to conduct more in-depth interviews with policy makers. The communities chosen were Yuma (no interaction), Mesa (successful interaction) and Lake Havasu (unsuccessful interaction). Structured open-ended interviews were conducted by telephone with mayors and council members from Yuma, Mesa, and Lake Havasu. The interview guide used for these is provided as Attachment X. Telephone calls were made to each policy maker in these communities and interviews were either scheduled or conducted at this initial contact. Interviews lasted from 30 to 60 minutes each. In some cases interviews were continued in a second telephone call. Of the 21 local level policy makers in these three communities, twelve completed interviews, including four from Yuma, three from Mesa and five from Lake Havasu. Page 3
Detailed notes were taken during the interviews and these were transcribed and expanded immediately after the interview had been completed. These notes were then organized topically and used to identify questions and response categories for a closed ended survey. The survey was reviewed and tested by individuals who have served as local level policy makers and by other involved in the policy process.
B. Identifying Policy Makers and Public Information
The Local Government Directory (January, 2000) published by the League of Arizona Cities and Towns and the Arizona Association of Counties, lists elected officials in every Arizona county, city, and town. This list included the policy makers' names and contact information. Gender was coded based on first name. The Directory also lists the occupation of all policy makers serving at the city or town level. These were recorded and those who are retired were noted. Those who are retired from or who currently work in education, health care, or the hospitality industry were also noted. The population of the jurisdiction and geographic area within jurisdictional limits were also taken from this source. Population density was calculated based on population and area. For cities and towns, the Directory identifies those that have a councilmanager form of government and those that do not. This information was added to each policy maker's record. Finally, the sales tax rate for cities and towns was collected for each city council member. Political party for each policy maker was obtained by calling the County Recorder in each county and asking for the party affiliation of each individual. Using the above sources, the information we had describing every policy maker was: � gender, � political party affiliation � jurisdiction (city or county), � name of county, � name of city or town for city or town council people, � population, geographic size and population density of the jurisdiction served, � type of government and sales tax rate for those serving cities and towns, � retirement status and employment in the education, health care, or the hospitality industry for those serving cities and towns.
C. Survey Distribution and Efforts to Increase Response Rate
An initial contact was made with a staff member in every city council/county board of supervisor office to verify the names of the policy makers and to identify an individual to shepherd the survey to and from the policy makers. A gift certificate for $25 at the store of the shepherd's choice was offered as an incentive to encourage a staff member to assist with distributing and collecting the surveys. Packets with introductory letters and surveys for each policy maker and information about distributing and collecting the surveys, were sent out the shepherds. Appendix 2 contains a sample of these materials. Specific return dates were stipulated for each shepherd.
Page 4
When packets were returned they were checked for completeness. Shepherds were contacted and asked to continue to try and get surveys from policy makers who had not responded. New letters and survey forms were mailed or faxed in many cases. When the shepherds reported that they could not generate any additional surveys, the individual policy makers were called on the telephone. Some asked to have the survey sent again by mail or fax and three completed the survey on the telephone.
D. Confidentiality
Policy makers were assured that their response to the questionnaire would not be associated with their name. Because the protocol called for a staff member to distribute and collect the surveys, no identifying information was included on the survey form itself, and a blank envelope was provided in which the policy maker could place his or her completed survey. Each survey form was coded with a unique identification number so that we could identify who had and had not responded to the survey. In some cases, the policy makers returned their surveys with the unique identification number removed, making it difficult to track who had and had not responded to the survey. When possible, we matched the survey with the individual in our data base based on demographic information. For example, if the survey indicated that the respondent was a woman and there was only one woman from whom we did not have a survey identified, we assumed the survey without the identification number was that woman. When that was not possible (e.g. when there were two women for who m we did not have a survey, and only one survey returned from a woman without an identification number) we generated a new ID number for the individual. This resulted in 23 additional identification numbers in our database.
E. Data Analysis
An ACCESS data file was developed which contained the basic demographic information we had for every policy maker (e.g. gender, political party affiliation, jurisdiction (city or county), name of county, name of city or town for city or town council people, populatio n, geographic size and population density of the jurisdiction served, type of government and sales tax rate for those serving cities and towns, retirement status and field of employment for those serving cities and towns. The appropriate TEPP local project was also identified for each policy maker. A second ACCESS data file was created for the survey information. The two files were merged by unique ID number and converted to an SPSS data file. All statistical analysis was conducted using SPSS routines. Results are reported as significant at the .05 level; in this report, exact significance levels are reported, rounded to two decimal places. Statistical tests of significance used in this report include chi square, ANOVA, and Pearson correlations. Scales were constructed using Principal Component factor analysis with Eigenvalues higher than 1.0 using the Oblimin rotation method.
Page 5
III. FINDINGS
A. Background: Who Are The Arizona Local Policy Makers?
Local level tobacco control policy-making can take place in a variety of jurisdictions, and at a variety of levels. Public policy making can occur through laws that are enacted in counties, cities and towns by county supervisors and mayors and city councils. School boards, health departments, and other governmental entities can also adopt tobacco-related policies or regulations. Tobacco-related policy can also be addressed in the private sector. This study focused on public policy making at the city/town council and county board of supervisors levels. Policies made that these levels have the most far reaching impact on the community. There 590 elected mayors and city council members serving in 87 municipalities in Arizona. The number who serve in each municipality ranges from five to nine, with the vast majority of municipalities having seven. Overall, 25.4% are female and 73.9% are male; we were unable to determine gender for four individuals (.7%). With the exception of Tucson and South Tucson, Arizona cities and towns have non-partisan elections for mayor and city council members. Candidates for these offices do not run as a member of any political party. However, most of these elected officials belong to a political party. Just under half (45.1%) of mayors and council members are Republicans, 38.6% are democrats, and 8% are members of other political parties, including Independents, Greens, and Libertarians. The party affiliation is unknown for 13.6% of mayors and council members. Some of these are not registered to vote according to the ir County Clerks who handle voter registration. There are 15 counties and 55 county supervisors in Arizona. All counties elect three supervisors with the exception of Coconino, Maricopa, Navajo, Pima and Yuma, which elect five. County government is much more male dominated than is city/town government. Twenty percent of those serving at the county level are female and 80% are male. County supervisors run in partisan elections. Figure 1 shows party affiliation of local policy makers. County government is more Democratic than the city/town governments. Democrats make up 61.8% of county supervisors; 38.2% are Republicans. No other political parties are represented at the county level. Considering the cities/towns and counties together, 25.0% of the policy makers are female, 74.4% are male and the gender of .6% is unknown. Party affiliation is 44.5% Republican, 40.6% Democrat, 2.5% other parties, and 12.4% unknown. Figure 1: Party Affiliation at the City/Town and County Levels
100% 75% 50% 25% 0% City/Town Republican Democrat County Ind/Green/Liber. All Unknown
45.1% 38.2% 42.7% 13.5% 38.6% 16.5% 38.2%
2.7% 61.8%
2.7%
Page 6
Local level policy makers come from a variety of professional backgrounds. The occupation of Mayors and city/town council members is listed in the Local Government Directory. The largest proportion describe themselves as business owners (24.6%), and the ne xt largest group is retired (22.0%). Appendix 3 lists the specific job titles that were grouped into the categories shown in Figure 2. The legend for this figure lists the occupational categories in descending order. Information on the occupations of county supervisors is not available. Figure 2: Occupation Categories for City/Town Council Members
Business Retired Service Education Unknown Laborer Professionals Public Service Health Care Homemakers Hospitality Sales Clerical Farm/Ranch Arts
Most communities elect mayors and city councils every two years, to serve staggered four year terms. The exceptions to this are the communities of Carefree, Cave Creek, Globe, Jerome, Miami, Nogales, Paradise Valley, and Tombstone, all of which elect a complete council every two years. At the county level, most boards of supervisors are elected every two years in their entirety with the exception of Cochise and Maricopa, which have staggered four year terms. Table 2 in Appendix 1 shows the election schedule for each local jurisdiction in Arizona. Getting elected is a public policy maker's prime goal. No matter how strongly he or she feels about the issues, getting elected is a prerequisite to being able to address those issues and therefore is paramount in a policy maker's mind. During election time, no matter what size the jurisdiction, candidates want to meet the voters and appeal to groups of voters with whom they share interests. Campaign time is an ideal time to educate incumbent and prospective policy makers about tobacco issues because at that time they are very interested in increasing their base of support. A strong and well-organized tobacco control community can have a real impact on the composition of public policy making bodies by providing information to candidates, demonstrating a large voting block, and mobilizing tobacco-control voters to work on political campaigns.
B. Sample Description
The 269 local level policy makers who responded to the survey represent 41.7% of all policy makers in Arizona. Among mayors and city council members the response rate was 41.9%. Surveys were received from 83.9% of the cities and towns. Every county was represented at the city/town level. Cities and towns not represented in the sample include: Bullhead City, Clifton, Colorado City, Douglas, Eloy, Fredonia, Huachuca City, Mammoth, Page, Pima, Prescott, Superior, Surprise, Tolleson, and Williams. Page 7
Surveys were received from 38.2% of the county supervisors, representing 66.7% of the counties. County boards of supervisors that are not represented in the sample include: Cochise, Graham, Greenlee, Pima and Navajo. Figures 3-5 compare the sample with the demographic information we have for all local level policy makers. We found no significant difference in gender, political party affiliation, or jurisdiction. In cities and towns, there was no difference in the form of government represented. Figure 3: Gender Comparison: All Policy Makers vs. Survey Respondents: Statistically equivalent
80% Percent 60% 40% 20% 0% Male Female Unknown 25% 28% 1% 1% 74% 71%
All Policy Makers
Survey Respondents
Figure 4: Party Affiliation Comparison: All Policy Makers vs. Survey Respondents: Statistically equivalent
50% 45% 43% 41% 38% 17%
Percent
40% 30% 20% 10% 0%
14% 3 % 3% Republican Democrat All Policy Makers Other
Unknown
Survey Respondents
Figure 5: Jurisdiction Representation Comparison: Statistically equivalent
100% 75% 50% 25% 0% Cities/Towns All Policy Makers Counties Survey Respondents 8.5% 7.8% 91.5% 92.2%
Page 8
The average age of the 269 survey respondents was 55.6 years (ranging from 26 to 80) and the average number of years in public office was 5.3 (ranging from 1-32). Those who serve at the county level have been in office significantly longer than those serving at the city/town level (f=32.535, p=.000) Figure 6 compares the number of years in public office for city/town and county policy makers. Figure 6: Average Number of Years in Public Office, By Jurisdiction
12 Number of Years 10 8 6 4 2 0 City County Total 4.8 5.3 11.1
With regard to tobacco use, 10.4% of the policy makers (n=27) responding to the survey report that they currently smoke tobacco. Of these, 48.1% are regular smokers , 40.7% smoke occasionally, and 9% are currently trying to quit. An additional 37.3% are former smokers (n=97), and 52.3% have never smoked (n=136). Only 2.7% prefer to sit in the smoking section of a restaurant; 85.3% prefer non-smoking and 12.0% have no preference. Almost half of all respondents (49.8%) report that they have someone close to them who has been ill or died due to a tobacco-related illness. Approximately equal proportions of males and females are currently smokers (10.2% of males, 11.0% of females), but females are more likely to have never smoked than males (chi square=8.629 p=.013). Figure 7 compares the percentage of males and females in each tobacco use category. Quitters are significantly older (60.6 years) than smokers (52.9 years) or never smokers (52.2 years) (f=17.511 p=.000). Figure 7: Smoking Status by Gender
100% 75% 50% 25% 0% Never smoked Quitter Males Females Smoker 65.8% 47.3% 42.5% 23.3% 10.2%1.0% 1
Page 9
C. Perceived locus of responsibility for public health and tobacco control
We asked the policy makers to indicate where they believe the responsibility for creating public health policy lies for a series of issues including: a. Protecting public health b. Limiting exposure to health risks in public places c. Guaranteeing clean indoor air in public places d. Guaranteeing clean indoor air in private workplaces e. Limiting the availability of tobacco to youth f. Controlling local advertising of tobacco products in retail settings, and g. Imposing local taxes, licensing, or zoning restrictions on businesses that sell tobacco products. Policy makers were asked to indicate if they believe the responsibility lies with the federal, state, county or city governments, by citizen initiative, or if they believe the issue is not an appropriate public policy issue for each policy area. We assessed the perception of the overall role of each level of government in creating public policy about the seven issues by summing the number of issues for which each policy maker identified each level of government as appropriate. We found that policy makers believe the responsibility lies with state and city government for more issues than any other level of government, and citizen initiative was considered appropriate for the least number of issues. Figure 8 shows that citizen initiative was seen as the appropriate level for creating public policy for an average of 3.8 of the seven issues, while the state and city were seen as appropriate for an average of 4.8 issues. Figure 8: Average Number of policy issues for which each level of government is perceived as having responsibility
7 6 5 4 3 2 1 0
4.2
4.8
4.5
4.8 3.8
Federal
State
County
City
Citizens
Preference for the state and city as the locus for creating public policy on the seven issues is also demo nstrated in Figure 9, which shows that 20.2% of local level policy makers saw a role for the city in every one of the seven issues, and 18.4% saw a role for the state in every issue. Citizen initiative was the level of government perceived to be least appropriate for creating public health policy. Only 8.2% saw this level of government as appropriate for addressing every one of the seven issues, and 42.7% saw it as appropriate for none of them. Although every county has a county health department, more than one in five (22.5%) of the respondents indicated they do not see a county responsibility for any of the issues, while only 15.0% indicated the county level of government as appropriate for all of the issues.
Page 10
Figure 9: Perceptions of the locus of responsibility for seven public health issues.
100% 75% 50% 25% 0% Federal State No Role County City Citizens Role in All Issues
1 13.5% 1.6% 12.7% 8.4% 1 22.5% 20.2% 15.0% 11.6% 42.7% 8.2%
The local policy makers see different roles for the various levels of government in creating public health policy for each of the seven issues we addressed (see Figure 9). While the majority of policy makers see protecting public health as a responsibility of all levels of government, when asked about more specific policies, different levels of government intervention are favored. For example, the federal government is most likely to be seen as the appropriate level of government for limiting the availability of tobacco to youth; the state is most frequently seen as the level of government that should be responsible for limiting exposure to health risks in public places, guaranteeing clean indoor air in public places, and limiting the availability of tobacco to youth. The city is likely to be seen as having responsibility for all of the issues. Although a majority of policy makers does not see a role for any one level of government in guaranteeing clean indoor air in private workplaces, those that do tend to locate the responsibility with the state and the city.
Page 11
Figure 9: Percent assigning policy responsibility to each level of government, by issue
100% 75% 50% 25% 0% a. b. Federal c. State d. County e. City f. g. a. b. c. d. e. f. Protecting public health Limiting exposure to health risks in public places Guaranteeing clean indoor air in public places Guaranteeing clean indoor air in private workplaces Limiting the availability of tobacco to youth Controlling local advertising of tobacco products in retail settings Imposing local taxes, licensing, or zoning restrictions on businesses that sell tobacco products.
Citizen
g.
a. b. c. d. e. f. g.
Federal State County City Citizen 74.5% 73.4% 67.0% 65.5% 43.1% 58.8% 70.4% 60.3% 70.8% 33.3% 49.1% 64.8% 58.4% 73.0% 30.3% 34.5% 46.1% 36.7% 45.3% 28.5% 69.8% 69.3% 56.6% 62.9% 36.3% 49.8% 52.1% 33.0% 41.9% 27.7% 23.6% 41.2% 36.0% 61.0% 16.1%
Page 12
D. The Salience of Tobacco Control
Local level policy makers deal with many issues, ranging from budgets to education, to maintenance of roads and sewers, to public safety and health. Even within the realm of public health, tobacco control is only one of many issues that demand the attention of policy makers. With so many issues to be considered, priorities are made. Raising the salience of an issue will increase the probability that it will be considered. In order to measure the salience of tobacco issues, we asked policy makers to rate the seriousness of a series of public health issues in their district on a scale of 1-10, where 1 means not serious and 10 means very serious, one of which was "tobacco use." The other issues chosen had been mentioned in the open-ended interviews with policy makers as things that they commonly deal with in the realm of public health. Figure 10 shows the average salience of each issue. Tobacco use scored relatively highly in terms of public health issue salience, exceeded only by drunk driving and access to health care. Figure 10: Average salience of public health issues
10 Seriousness 8 6 4 2 0 a b c d e f g 6.4 6.1 6.0 5.3 a. b. c. d. e. f. g. Drunk driving Access to health care Tobacco use Air quality Water quality Immunization Hazardous waste
5.1
4.9
4.6
Figures 11-14 show significant differences related to salience. The salience of tobacco use is significantly higher among female policy makers than among men (f=8.829, p=.003), higher among those who have had someone close to them be ill or die due to a tobacco related illness (f=4.527 p=.034) and higher among Democrats than among Republicans (f=3.301, p=.039). The largest significant difference in salience was between those who prefer the smoking section of a restaurant or who have no preference in restaurant seating, versus those who prefer the nonsmoking section (f=9.758, p=.000). Salience was also significantly related to popula tion density, being more salient in higher density jurisdictions Figure 11: Salience of Tobacco Use by Restaurant Seating Preference
10
Figure 12: Salience of tobacco use by gender
10
Seriousness
Seriousness
8 6 4 2 0 Smoking No Preference 4.17 4.29
6.33
8 6 4 2 0 Male 5.7
6.8
Non-smoking
Fema e Page l13
Figure13: Salience of tobacco use by political party affiliation
10
Figure 14: Salience of tobacco use by having had someone close be ill or die due to a tobacco related disease
6.6
Seriousness
8 6 4 2 0 Republican 5.6
6.0
9
Seriousness
7 5 3 1
5.6
6.3
Other
Democrat
No
Yes
E. Knowledge and Attitudes about Tobacco and Tobacco Policy
Knowledge and attitudes about tobacco and tobacco policies were measured by five statements for which policy makers were asked to indicate the degree to which they agree on a scale of 1-4 where 1 means strongly disagree and 4 means strongly agree. The statements and the average response are indicated below:
Strongly Disagree Strongly Agree
1
2
3
4 ^3.4
a. Secondhand smoke creates a serious health risk for non-smokers decisions about public tobacco policies b. The little bit of smoke you inhale in public places where smoking is permitted is not enough to hurt you c. Smokers have a right to smoke wherever they want d. The majority of Americans support strong tobacco control policies e. The majority of my constituents support strong tobacco control policies
^1.9 ^1.4 ^2.9 ^2.8
Page 14
Gender was significantly related to agreement that secondhand smoke creates a serious health risk for non-smokers (see Figure 15). Among females, the average level of agreement was 3.7, while among males it was 3.4 (f=7.301, p=.007). Figure 15: Secondhand smoke creates a serious health risk for non-smokers: by gender
4 3 2 1 0 Males Females 3.4 3.7
Knowledge and attitudes about tobacco and tobacco policy are strongly related to the perceived salience of tobacco use as a public policy issue. For example, the more strongly a policy maker agrees that secondhand smoke creates a serious health risk for non-smokers, the more serious a proble m he or she believes tobacco use is in his or her district. Alternatively, the more strongly a policy maker agrees that smokers have a right to smoke wherever they want, or that the little bit of smoke you inhale in public places where smoking is permitted is not enough to hurt you, the less serious he or she believes tobacco use to be. Table 1 summarizes the statistical relationships between salience and the knowledge and attitude items. Table 1: Correlation with perceived seriousness of tobacco use in your district Secondhand smoke creates a serious health risk for non-smokers r=.407 p=.000 The little bit of smoke you inhale in public areas where smoking is permitted is not enough to hurt you Smokers have a right to smoke wherever they want The majority of Americans support strong tobacco control policies The majority of my constituents support strong tobacco control policies r=-.319 r=-.172 r=.137 r=.147 p=.000 p=.007 p=.031 p=.022
Disagree ---- Agree
Page 15
Policy makers' knowledge and attitudes about tobacco and tobacco policy are also strongly related to their personal choices about exposure to secondhand smoke, as shown in Figure 16.. Figure 16: Knowledge and attitudes about tobacco and tobacco control by personal choice about exposure to secondhand smoke
Disagree ----- Agree 4 3 2 1 0 a Smoking section b c d e c. d. e.
2.0 3.7 2.2 2.7 2.4 1.8 2.3 2.1 1.8 3.0 2.9 2.6 2.5 2.5 2.3
a. b.
No preference
Non-smoking section
Secondhand smoke creates a serious health risk for nonsmokers (f=86.478 p=.000) The little bit of smoke you inhale in public areas where smoking is permitted is not enough to hurt you (f=14.012 p=.000) Smokers have a right to smoke wherever they want (f=24.447 p=.000) The majority of Americans support strong tobacco control policies. (f=7.389 p=.001) The majority of my constituents support strong tobacco control policies. (f=6.962 p=.001)
Page 16
F. Who Do You Trust?
While policy makers at the state and federal level are strongly and overtly influenced by campaign contributions and the special interest groups that make them, these influences are not exerted as directly at the local level. Special interests operate through local community structures to influence tobacco policy. For example, the tobacco industry enlists business groups to fight tobacco control proposals, while efforts to create tobacco control policy are supported by public health organizations. We were interested in the degree to which the opinions of specific interest groups influence local level policy makers when considering tobacco issues. We asked policy makers to rate the degree of influence each of the following sources of information have on their thinking about tobacco issues: national medial experts, health professionals in hour community, county health department staff, the American Cancer Society, the American Lung Association, business groups such as the Chamber of Commerce and local restaurant association, individual business owners, citizen anti-tobacco groups, citizen protobacco groups, youth, and the local tobacco education and prevention project. Figure 17 shows the responses to this series of questions. Ove rall trust is highest for medical sources � more than half of the policy makers state that they are strongly influenced by the opinions of national experts and local medical professionals. Just under half report they are strongly influenced by the voluntary organizations (Cancer and Lung). Policy makers trust local health programs, such as the health department and the local tobacco project somewhat less � less than a third report that they are strongly influenced by these. The opinions of youth are valued as much as the opinions of local health programs are valued. Under 10% report that they are strongly influenced by citizen anti-tobacco groups and business interests, and only 4% report that they are strongly influenced by pro-tobacco citizen groups. Figure 17: Degree of Influence of Various Sources
100% 75% 50% 25% 0% a b c Strong d e f g Little h i None j k a. b. c. d. e. f. g. h. i. j. k. National medical experts Health professionals in your community American Cancer Society American Lung Association County health department staff Local tobacco education and prevention project Youth Citizen anti-tobacco groups Individual business owners Business groups Citizen pro-tobacco groups
Moderate
A factor analysis confirmed that there are three basic dimensions of influence on policy makers' thinking about tobacco issues. They are (1) Medical/health interest groups: National medical experts Health professionals in your community American Cancer Society American Lung Association County health department staff Page 17
(2) Business interest groups:
Business groups (Chamber of Commerce, Restaurant Association) Individual business owners Citizen anti-tobacco groups Citizen pro-tobacco groups Youth Local tobacco projects
(3) Citizen interest groups:
It is notable that local tobacco projects are not part of the medical/health interest group cluster, but as part of the citizen interest group cluster. This suggests that local tobacco project staff is not perceived as health experts but as part of the grassroots community. We created indexes of influence of medical/health, business, and citizen group sources by calculating the average degree of influence for the items in each category. On a scale of 1-4, where 1 means no influence and 4 means strong influence, the average scores on the influence indexes were:
No influence Strong influence
1 Medical/health interest group influence Citizen interest group influence Business interest group influence
2
3
4
^3.28 ^2.54
^2.32
Scores on the three indexes were significantly correlated � the higher the score on medical/health group influence, the higher the score on business group and citizen group influence. This suggests that policy makers are influenced by medical and health interest groups the most, but the more they are influenced by them, the more they are also influenced by other groups. Testing for differences in the influence of the three sources of influence we found that female policy makers are significantly more likely to trust medical sources than are males (f=7.171, p=.008). Population density of the jurisdiction was also significantly related to the influence of medical/health interests (p=.006) and citizen interests (p=.005), but not to business interests. These groups have more influence in more densely populated communities than in less densely populated ones. No differences were found in comparing policy makers by their political party affiliation, by jurisdiction or by form of government. Age was significantly related to the influence of business and citizen groups. The older the policy maker, the less they trust both business (p=.007) and citizen (p=.000) interest groups. Number of years in office, however, was not related to influence by these groups (although older policy makers were found to have held office significantly longer). This suggests that mistrust of the opinions of business and citizen groups is not a function of time in office, but only of age.
G. What types of information are preferred by local level policy makers?
Policy makers at every level must make decisions about important and very complicated issues that will have an impact on the communities that they serve. While each policy maker brings his or her own expertise to the policy debate, it is not possible for any policy maker to have expertise Page 18
about every issue that is considered. The questionnaire asked about preferences for some specific information resources that are commonly used by policy makers, and asked the policy makers to rate various information types, formats and sources in terms of their decision making process. We asked how much the following types of information would influence policy maker decisions on local tobacco policy issues: scientific information about health effects, business/economic concerns, letters and phone calls from community members, newspaper editorial board positions, letters to the editor, fellow board- member positions, and personal experience. Respondents could rate each of the seven types on a scale of 1-4, where 1 meant no influence and 4 meant strong influence. Scientific information and their own personal experience are rated higher than any other types (see Figure 18).
Figure 18: Influence of information types on local policy maker decisions about tobacco policy
100% 75% 50% 25% 0% a b Strong c d e Little f None g a. b. c. d. e. f. g. Scientific information about health effects Personal experience Letters and phone calls from community members Business/economic concerns Fellow board-member positions on the issue Newspaper editorial board positions Letters to the editor
Moderate
H. What resources do policy makers have for gathering and interpreting information?
Having to deal with a very broad range of issues, policy makers cannot be experts in all of them. They must rely on others to provide background and information about many of the issues they must consider. The resources they have for gathering information may determine the position they take on an issue. We looked closely at two types of resources that policy makers might use to learn about tobacco issues � staff members who can gather and synthesize information for the policy maker, and the internet. Staff Most local level policy makers (62.4%) always have staff support for gathering information about policy issues they are considering. Another 19.8% report that they freque ntly have staff support, 11.6% sometimes have support, and 6.2% never have staff support. Those serving at the Page 19
city/town level were more likely to have staff support if they served in a council/manager form of government.(Chi square =7.948 p=.047). There was no relationship between staff status and whether the jurisdiction was a city/town or county, the population or population density of the jurisdiction served, or personal characteristics of the policy maker, such as age, gender, or years in office. Figures 19 and 20: Cities/Towns: Do you have staff support to gather information about policy issues being considered by the council/board? By type of Government
Council/Manager
Other Form of Government
Never Sometimes Frequently Always
Never Sometimes Frequently Always
I. Internet Capacity Another resource that can be used to gather information about policy issues is the internet. More than three quarters (76.7%) of the policy makers reported that they have personal access to the internet. There were no gender differences regarding personal access to the internet. However, age was significantly rela ted to personal internet access; the average age of those with personal access to the web was 53.6 years, while the average age of those without personal internet access was 61.8 years (f=23.655 p=.000). Less than a third (29.0%) of policy makers report that their staff frequently uses the internet to look for information about public policy topics being considered; 40.6% report that their staff uses it sometimes, 17.0% occasionally use it, and 13.4% never use it. Among those serving at the city/town le vel, the type of government is significantly related to personal internet access and to staff use of the internet (see Figure 21). City/town policy makers serving in a council/manager form of government were significantly more likely to have personal access to the web than are those that serve in some other type of government (Chi square=20.695 p=.000). Almost three quarters (72.0%) of policy makers' staff serving in council/city manager governments use the internet to look for information, compared to 42.9% of those who serve in types of city/town government. (chi square=10.367 p=.016). Figure 21: City/Town Personal Internet Access by Type of Government
100% 75% 50% 25% 0% Council/Manager Staff use Other govt. Personal Access 72.0% 81.2% 49.2% 43.3%
Page 20
The degree of internet capacity varies greatly by local project area. Table 2 shows the percentage of responding local policy makers who report having personal internet access by Local Project. Table 2: Personal Internet Access by Local Project Area Local Project Number % with reporting access Apache 9 66.7% Cochise 17 82.4% Coconino 8 75.0% Gila 18 66.7% Graham 5 100.0% Greenlee 5 40.0% LaPaz 8 75.0% Maricopa: Mesa 4 100.0% Maricopa: Northern 10 70.0% Maricopa: Scottsdale 6 100.0% Maricopa: SouthCentral 6 100.0% Maricopa: Southeast Valley 14 100.0% Maricopa: TAG/TUP 7 71.4% Maricopa: TLC 12 66.7% Maricopa:Western 24 79.2% Mohave 4 25.0% Navajo 24 83.3% Pima 13 92.3% Pinal 16 56.3% Santa Cruz 8 50.0% Yavapai 21 81.0% Yuma 12 75.0% Total 252 76.7% Reported Use of the Internet While more than three quarters of local policy makers have access to the internet, only 54.1% of those use it regularly, 30.4% use it sometimes and 15.5% have never used it or have only tried it. Having personal internet access is strongly related to using it (chi square=161.321 p=.000), and to using it specifically to look for information about a current public policy topic (chi square=93.242, p=.000). Those with personal internet access are also more likely to use information from the web it if were made available to them (chi square=35.801 p=.000).
Page 21
Figure 22: How likely are you to use information on the internet when you consider a public policy health issue?: Comparison of those with and without personal internet access
100% 80% Percent 60% 40% 20% 0% Would use Have internet access Would not use 53% 15% 47% 85%
Do not have internet access
Whether or not a policy maker would use information from the internet is strongly related to the degree of trust he or she has in that information source. Overall, only 28.1% say they strongly trust information from the internet. The majority (64.1%) say they trust internet information somewhat and 7.8% do not trust it at all.
Use of the internet in general, is significantly related to age (see Figure 23). The older the policy maker, the less likely he or she is to use the internet (f=11.712 p=.000). Figure23: How frequently do you use the internet? By Age
70 Age in Years 60 50 40 1 2 3 4 Never --- Regularly
62.4 57.5 52.3 52.2
County supervisors are significantly more likely to report that they frequently or sometimes use the internet than are policy makers serving at the city/town level. This finding is independent of age. That is, we tested to see if county supervisors happen to be younger that those serving at the city/town level, but there was no significant age difference between the two groups. Sixty- five percent of county level policy makers use the internet frequently or sometimes, while only 41% of city/town level policy makers do so. Page 22
I. How do local policy makers prefer to hear from their constituents?
We asked policy makers the degree to which they prefer various types of contact from constituents (including letters, e- mail, faxes, telephone calls to the council office, telephone calls to the home, telephone calls to the place of business, face to face meetings, inviting the policy maker to events or meeting with the policy maker's staff). Preferences for constituent contact varied considerably among policy makers. The most preferred method of contact was by letter: 89.9% of all policy makers prefer to be contacted by letter. Setting up a meeting was preferred by 64.1%, fax contact was preferred by 63.5% and e- mail contact was preferred by 62.9%. No other type of contact was preferred by more than half of the policy makers. Figure 24 shows the level of preference for each type of contact: Figure 24: Constituent Contact Preferences
100% 75% 50% 25% 0% a b
4 a. b. c. d. e. f. g. h. i. Write a letter Send an e-mail Schedule an appointment for a meeting Send a fax Meet with my staff Telephone call to the council office Telephone call to my home Invite me to an event Telephone call to my place of business
c
d
3
e
2
f
g
1
h
i
Strongly prefer -----------------Do not prefer
Factor analysis of the preferred contact items showed that overall, responses clustered into three categories: (1) Face-to-Face contact: Schedule an appointment for a meeting Invite me to an event Meet with my staff Send an e- mail Send a fax Telephone call to the council office Telephone call to my home Telephone call to my place of business
(2) Formal contact
(3) Informal contact
On a scale of 1-4, where 1 means "do not prefer" and 4 means "strongly prefer," policy makers most prefer either formal (mean=2.5) or face-to-face (mean=2.5) contact, over informal (mean=1.8) contact (see Figure 25). Female policy makers were significantly more likely to prefer informal (f=8.932 p=.003) and face-to- face (f=4.297 p=.039) contact than were male policy makers. Page 23
Figure 25: Constituent Contact Preference Scales
4 3 2 1 0 Formal Face-to-face Informal 2.5 2.5 1.8
Writing a letter was not clearly identified with any of the three factors, but was a component of all three. This analysis suggests that most policy makers prefer formal contact (e- mails, faxes, and telephone calls to the council or supervisor offices), the most policy makers, but particularly women prefer face-to-face contact, and that informal contact is not recommended unless you know specifically that a particular policy maker prefers it. Those that do prefer it are more likely to be women. No matter what the strategy for contacting policy makers is, letter writing should be part of it. In addition to asking about their preferred methods of constituent contact, we also asked about the format in which local level policy makers prefer to receive information. Figure 26 shows that detailed reports , brief fact sheets and technical studies are the most preferred. Video presentations, internet based information and annotated bibliographies are less likely to be used. Figure 26: Preferred information formats
100% 75% 50% 25% 0% a b 4 c 32 d 1 e f a. b. c. d. e. f. Detailed reports Brief one page fact sheets, pamphlets or brochures Copies of technical/scientific studies Video tapes presentations Information on the internet Annotated bibliographies
Definitely would use --- Definitely would not use
Page 24
IV. CONCLUSION
Successful policy advocacy depends on building strong, trusting, and lasting relationships with local level policy makers. The findings of this study suggest specific actions local tobacco projects and their coalitions can take to accomplish this in the policy arena. For example, this study found that most policy makers trust medical sources more than citizen groups or business interests when considering health and tobacco policy issues, and that Arizona's local tobacco projects are currently viewed as "citizen groups." That perception should be changed in order to increase the level of trust local policy makers have in the local tobacco projects. Coalitions should include recognized medical and health care experts from the community and these individuals should take a leading role in communicating with policy makers and advocating for specific policy changes. While the relationship between the coalition and the project should be highlighted, these efforts should also be coordinated with other health advocacy groups in the community. Local project staff members, who are prohibited from direct lobbying activities, should establish a relationship with local policy makers by providing them with medical and scientific information on tobacco issues on an ongoing basis. Supplying published articles along with a brief summary of the findings would be a welcome approach. The majority of local policy makers do recognize a role for local government in protecting public health, limiting exposure to health risks in public places, guaranteeing clean indoor air in public places, and limiting the availability of tobacco to youth. These issues are likely to be better received by policy makers than issues such as guaranteeing clean indoor air in private workplaces, and controlling local tobacco advertising in retail settings, which are not viewed by the majority as appropriate for local government intervention. Most local policy makers are aware of ETS as a health hazard, but they minimize the effect of secondhand smoke in public places, and therefore do not necessarily support clean indoor air policies. They also underestimate public support for strong tobacco control policies. Education on these issues is needed. Finally, while public health and selected tobacco issues are viewed by local level policy makers as being within the purview of local government, our data suggest that public health issues, including tobacco control, are not seen as being particularly salient by local level policy makers. Salience is related to knowledge, however, and education of policy makers may serve to increase the salience of tobacco issues in their otherwise full agendas. Salience is also related to perceptions of constituent support for strong tobacco control policies. These findings support an approach where local project staff provide timely scientific information and coalitions demonstrate broad community support in order to raise the salience of tobacco issues among local level policy makers, while medical experts are prominent among those enlisted to address health issues related to specific policy proposals.
Page 25
Appendix 1 Structured, Open-ended Interview Outline Policy Maker Interviews:
� � � � � �
U of A study of local level policy makers. Interested in how policy makers access information about health-related topics and how community interest groups influence their decis ions. Focus of the interview is around tobacco issues. We are interviewing all of the city council/county supervisors in three communities � Mesa, Lake Havasu, and Yuma in order to gain an understanding of the issues. The information will be used to frame the questions we will ask in a brief telephone survey of all city council/county supervisors in Arizona Confidential, no names
1. How long have you served? 2. Has the council/supervisors considered any tobacco issues since you were elected? � What were the issues? � Who brought it before the council? � Who or what organizations were involved in the discussion? � What arguments were made on both sides? � What argument do you think was the most persuasive? Why? � What argument most influenced the outcome of the vote? Why? 3. What role do you think local government should play in: � protecting public health � limiting youth access to tobacco, � creating smoking bans in public places including restaurants, � restricting sales and advertising 4. What is the most effective way for someone with an interest in an issue like tobacco policy to contact you? What kind of information is most meaningful to you? What format do you prefer when someone provides you with information? � phone, mail, e-mail, meeting, talk to aide � reading material, web sites, data 5. How much do you trust the information provided by: What do you think their biases are? � The medical community (e.g. doctors and organizations like the Cancer Society, Lung Association, Heart Association etc.) � The public health community (e.g. city/county health department) � The business community (restaurant association, chamber of commerce, large and small business owners) � Individual concerned citizens � Youth � Any other players identified by the interviewee 6. Who do you see as the "experts" on tobacco issues when it comes to public policy decisions? Page 26
7. How much of an influence on your opinion are... � Editorials � Scientific studies � Studies conducted locally � Health professionals � Tobacco industry � Health department officials � Your colleagues � Family and friends � Constituents � Your intuition 8. Are you familiar with the Local Project? � Mohave County Tobacco Prevention Program (McTUPP) (Susan Williams) � Mesa Partnership for Tobacco-Free Youth and Community (Johnna Switzer) � The tobacco program at the Yuma County Department of Public Health (Donna Miller) � What kinds of things does this program do in your community? � Have you ever participated in any activities sponsored by the Local Project? Which ones, in what capacity? � Do you personally know anyone who is a member of the local tobacco coalition? � Have you had any other kind of contact with the Local Project � describe... 9. Personal Information � Gender, � Party � Age � Have kids at home? � What organizations, both professional and recreational do you belong to? � Have you ever used tobacco? Do you use tobacco now?
Page 27
Appendix 2 The following questions address how you receive and use information on public policy issues. Please circle or check your responses. 1. Do you have staff support to gather information about policy issues being considered by the council/board? _____ Always
4
_____ Frequently
3
_____ Sometimes
2
_____ Never
1
2. If a constituent wanted to contact you about a tobacco policy issue, what would you prefer he or she do? Do Not Prefer
a. Write a letter b. Send an e-mail c. Send a fax d. Telephone call to the council office e. Telephone call to my home f. Telephone call to my place of business g. Schedule an appointment for a meeting h. Invite me to an event i. Meet with my staff j. Other (Please specify: _______________________________ __________________________________________________) 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3
Strongly Prefer
4 4 4 4 4 4 4 4 4 4
3. How much would the following types of information influence your decisions on local tobacco policy issues?
S
trong
Influence 1 1 1 1 1 1 1 2 2 2 2 2 2 2
No
3 3 3 3 3 3 3
a. Scientific information about health effects b. Business/economic concerns c. Letters and phone calls from community members d. Newspaper editorial board positions e. Letters to the editor f. Fellow board-member positions on the issue g. Personal experience
Influence 4 4 4 4 4 4 4
Page 28
h. Other (Please specify: _______________________________ ___________________________________ _______________)
1
2
3
4
4. How much influence would the opinions of each of the following sources of information have on your thinking about tobacco issues in your locality?
a. National medical experts b. Health professionals in your community c. County Health Department Staff d. The American Cancer Society e. The American Lung Association f. Business groups (Chamber of Commerce, Restaurant Assoc) g. Individual business owners h. Citizen anti-tobacco groups i. Citizen pro-tobacco groups j. Youth k. The local tobacco education and prevention project
No Influence 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3
Strong Influence 4 4 4 4 4 4 4 4 4 4 4
5. How likely are you to use the following information formats when you consider a public policy health issue?
Definitely not use 1 1 1 1 1 1 Definitely would use 4 4 4 4 4 4
a. Detailed reports b. Copies of technical/scientific studies c. Annotated bibliographie s d. Brief one page Fact Sheets, pamphlets or brochures e. Video taped presentations f. Information on the internet (web)
2 2 2 2 2 2
3 3 3 3 3 3
Page 29
6. Are there any other information formats you rely on when considering a public policy health issue? _____ No
0
____ Yes (Please specify:
1
)
The following questions are about e-mail and the internet/worldwide web. Please check your responses. Please check your responses. 7. Do you have personal access to: a. e-mail?
______ No
0 0
______Yes
1
b. the internet (worldwide web)? ______ No 8. How frequently do you use: a. e-mail ? b. the internet? ________
regularly 4 regularly 4
______Yes
1
sometimes3 sometimes3
________ ________
tried it 2 tried it 2
________
never1 never1
________
________ ________
________
9. How comfortable are you seeking information on the internet (worldwide web)?
_____ Very 4 Comfortable _____ Somewhat 3 Comfortable _____ Not comfortable 2 but anxious to learn _____ Not comfortable 1 and probably won't use it
10. Do you ever use the internet (worldwide web) to look for information about a public policy topic you are considering?
_____ Frequently
4
_____ Sometimes
3
_____
2
Occasionally
_____ Never
1
11. Does your staff ever use the internet (worldwide web) to look for information for you on a policy topic you are considering?
_____ Frequently
4
_____ Sometimes
3
_____
2
Occasionally
_____ Never
1
12. How much would you trust information about public policy topics that comes from the internet?
_____ Totally
4
_____ A great deal
3
_____
2
Somewhat
_____ Not at all
1
Page 30
The following questions are about your opinions. 13. How much do you agree or disagree with the following statements? (circle your response)
Strongly Disagree Strongly Agree
a. Secondhand smoke creates a serious health risk for non-smokers b. Health issues should take precedence over business concerns in making decisions about public tobacco policies III. c. The little bit of smoke you inhale in public areas where smoking is permitted is not enough to hurt you. d. Smokers have a right to smoke wherever they want. e. If it is clear that my constituents do not want it, I will not vote for something even if I think is right. f. The majority of Americans support strong tobacco control policies. g. The majority of my constituents support strong tobacco control policies.
1 1 1 1 1 1 1
2 2 2 2 2 2 2
3 3 3 3 3 3 3
4 4 4 4 4 4 4
14. Who do you believe has the responsibility for creating public policy for each of the following issues? Please circle all that apply.
Federal government a. Protecting public health b. Limiting exposure to health risks in public places. c. Guaranteeing clean indoor air in public places. d. Guaranteeing clean indoor air in private workplaces e. Limiting the availability of tobacco to youth f. Controlling local advertising of tobacco products in retail settings g. Imposing local taxes, licensing, or zoning restrictions on businesses that sell tobacco products 1 1 1 1 1 1 State government 2 2 2 2 2 2 County government 3 3 3 3 3 3 City government 4 4 4 4 4 4 Citizen initiative 5 5 5 5 5 5 Not an appropriate public policy issue 6 6 6 6 6 6
1
2
3
4
5
6
15. On a scale of 1-10, where 1 means not serious and 10 means very serious, how serious are problem are the following health issues in your district? a. Access to health care _____ e. Hazardous waste _____ b. Water quality _____ f. Drunk driving _____ c. Tobacco use _____ g. Immunizations _____ Page 31 d. Air quality _____
The last questions are about personal information. Remember this survey is confidential-- all of the findings will be reported only in the aggregate. Please fill in or check the answers that describe you:
16. Age : _____________ 17. Gender: _____ Male
0
18. Number of Years in Office: _______ years
_____Female
1
19. Tobacco use status: ___ Current regular 1 smoker
___ Current occasional
2
smoker
___ Current smoker
3
trying to quit
0
___ Former
4
Smoker
1
___ Never
5
Smoked
20. Has someone close to you been ill or died due to a tobacco-related illness? _____No 21. When you go to a restaurant, where do you prefer to sit? _____ smoking section
1
_____Yes
_____ non-smoking section
2
_____ no preference
3
Thank you!
Page 32
APPENDIX 3 CLASSIFICATION OF OCCUPATIONS OF MUNICIPAL ELECTED OFFICIALS
CATEGORY Arts Business Occupations Artist Potter Advertising executive Broker marketer Building contractor Business owner Businessman/woman Car dealer CEO Contractor Distributor Insurance agent/sales Investments Publishing Real estate broker Real estate developer Real estate/realtor Self employed Title specialist Accounting clerk Bookkeeper Cashier Clerk Paralegal Secretary Administrator/faculty associate College administration College English teacher College student Director of education Educator Flight instructor Migrant Head Start Center director School aide School counselor School custodian School district School principal Student Teacher Teacher's aide University of Arizona Dairyman Farmer Page 33
Clerical
Education
Farming/Ranching
CATEGORY Health
Homemaker Hospitality
Labor
Labor (continued)
Occupations Landscape management Ranch owner Certified dental assistant Chiropractor Dentist EMT Health and safety inspector Health director Medical administrator Mt. Graham hospital Nurse manager Nurse, R.N. Oncology account manager Physician Psychologist Public and environmental health specialist Respirator room attendant V.A. Hospital Veterinarian Homemaker Housewife Food service manager Hotelier Motel owner Restaurant manager Restaurant owner Restaurateur Waitress ASARCO Ray Mine Auto technician Builder Construction Cook Diesel mechanic Electronic technician Equipment operator Field mechanic Hair stylist Instrumentation technician Laborer Machinist Maintenance technician Manufacturing Mechanic Operator SRP Paper mill Phelps Dodge Railroad engineer Page 34
CATEGORY
Professionals
Public Service
Sales
Service Service (cont)
Occupations Truck driver Utility service Welder Accountant Architect Attorney Civil engineer Consulting engineer CPA Engineer Nuclear engineer Systems engineer Adult probation specialist Civil service Councilman/woman County employee Court clerk Deputy sheriff Government employee Parks and recreation Police chief Postal employee Probation Public works Relocation Commission Director Senior citizens director Sheriff's department Antique dealer Gallery owner Market manager Retail management Retail/retailer Sales consultant Sales manager Sales representative Sales/salesman Vehicle sales Account manager Administrator Banker Business representative Clergy Client services Computer data assistant Computer systems manager Construction management Consultant Contract manager Page 35
CATEGORY
Occupations Control room operator Controller Director/Executive Director District manager Drafter Electric utilities Escrow branch manager Event producer Financial analyst Fire administrator General manager H.R. facilitator Housing America Human resource manager Interior design Loan officer Lumber store manager M.H. Park Manager Manager Manager � food store Media director MIS director Mortgage broker Operations manager Pest control Powerhouse leadman President Production manager Project coordinator Project manager Property manager Senior financial credit analyst Smelter supervisor Supervisor Utility executive
Page 36
Appendix 4: Information by Local Project Table 1: Number of Policy Makers Reporting by Local Project Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Unknown Total Number reporting 9 18 8 21 5 5 9 1 4 10 7 6 14 7 12 25 5 26 14 17 10 22 13 1 269
Page 37
Table 2: Election Cycles for Local Arizona Jurisdictions Two year terms expire Four year terms expire Municipalities Apache Junction June odd numbered years Avondale Dec. odd numbered years Benson June odd numbered years Bisbee Dec. eve n numbered years Buckeye May even numbered years Bullhead City June odd numbered years Camp Verde June odd numbered years Carefree June odd numbered years Casa Grande June odd numbered years Cave Creek June odd numbered years Chandler June even numbered years Chino Valley June odd numbered years Clarkdale June even numbered years Clifton May even numbered years Colorado City May even numbered years Coolidge June even numbered years Cottonwood May odd numbered years Douglas June even numbered years Duncan June odd numbered years Eager July even numbered years El Mirage June even numbered years Eloy June even numbered years Flagstaff June even numbered years Florence May even numbered years Fountain Hills June even numbered years Fredonia July even numbered years Gila Bend June odd numbered years Gilbert June odd numbered years Glendale June even numbered years Globe May even numbered years Goodyear June odd numbered years Guadalupe May odd numbered years Hayden June odd numbered years Holbrook May odd numbered years Huachuca City May odd numbered years Jerome June even numbered years Kearny May even numbered years Kingman June even numbered years
Table 2 (continued)
Page 38
Two year terms Lake Havasu City Litchfield Park Mammoth Marana Mesa Miami Nogales Oro Valley Page Paradise Valley Parker Patagonia Payson Peoria Phoenix Pima Pinetop-Lakeside Prescott rescott Valley Quartzite Queen Creek Safford Sahuarita St. Johns San Luis Scottsdale Sedona Show Low Sierra Vista Snowflake Somerton South Tucson Springerville Superior Surprise Taylor Tempe Thatcher Tolleson Tombstone Tucson Wellton Wickenburg
Four year terms, staggered Nov. even numbered years June even numbered years June even numbered years May odd numbered years June even numbered years
June even numbered years Dec. even numbered years May even numbered years June odd numbered years April even numbered years May odd numbered years June even numbered years May even numbered years June odd numbered years Dec. odd numbered years Dec. even numbered years May odd numbered years Nov. odd numbered years June odd numbered years June even numbered years May even numbered years May even numbered years May odd numbered years June odd numbered years June even numbered years June even numbered years June even numbered years June even numbered years June odd numbered years June odd numbered years May odd numbered years June odd numbered years June even numbered years June odd numbered years June odd numbered years May odd numbered years July even numbered years June even numbered years June odd numbered years Nov. even numbered years Dec. odd numbe red years May odd numbered years May even numbered years
Page 39
Table 2 (Continued)
Two year terms Willcox Williams Winkelman Winslow Youngtown Yuma Counties Apache Cochise Coconino Gila Graham Greenlee La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Four years staggered terms June even numbered years June even numbered years June even numbered years May even numbered years May odd numbered years Dec. odd numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years Dec. even numbered years
Dec. even numbered years
Table 3: Political Party of Survey Respondents by Local Project Republican Democrat IndepenLocal Project dent Apache 0 1 0
Green 0
Libertarian 0
Not Known 8 Page 40
Cochise Coconino Gila Graham Greenlee LaPaz Maricopa Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: SE Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Unknown Total
8 1 7 0 1 3 1 1 5 7 3 8 2 7 17 5 16 6 3 1 9 4 115
7 6 13 5 4 3 0 1 0 0 1 1 4 4 5 0 10 5 11 8 5 8 102
0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 5
0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
3 0 0 0 0 3 0 2 5 0 2 5 1 1 1 0 0 3 2 1 7 0 1 45
Table 4: Tobacco Use Status of Survey Respondents Local Project Current Current Regular occasional Smoker Smoker Apache Cochise 0 0 0 0
Current smoker, trying to quit 0 0
Former Smoker 3 10
Never Smoked 6 5 Page 41
Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
1 5 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 2 0 2 0 13
0 1 0 2 1 0 0 0 1 0 0 0 0 0 1 0 2 0 0 2 1 11
0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 3
1 5 2 0 3 1 1 5 3 2 2 2 5 9 2 11 6 8 4 9 3 97
6 10 3 3 3 0 3 5 2 3 12 5 6 14 2 13 6 7 5 7 9 135
Table 5: Restaurant Seating Preference of Survey Respondents Local Project Smoking Non Smoking No Preference Apache 0 8 1 Cochise 0 14 2 Coconino 0 7 1 Gila 2 15 4 Graham 0 5 0 Greenlee 1 2 2 LaPaz 1 5 2 Maricopa (countywide) 0 1 0 Maricopa: Mesa 0 4 0 Page 42
Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0 0 0 0 0 0 0 0 2 0 1 0 0 0 7
10 5 5 13 7 10 18 4 23 13 14 7 17 13 220
0 2 0 0 0 1 6 1 0 1 2 3 3 0 31
Table 6: How much do you agree or disagree that secondhand smoke creates a serious health risk for non-smokers?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Strongly Disagree 0 1 0 3 0 1 0 0 0 Disagree 0 3 0 4 0 1 3 0 0 Agree 1 2 3 5 1 0 1 0 0 Strongly Agree 8 11 5 8 4 3 4 1 4 Page 43
Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0 0 0 1 0 0 2 0 0 2 1 0 0 0 11
0 3 0 0 0 2 3 1 1 1 1 3 3 0 29
3 1 1 3 1 1 9 2 3 4 5 1 4 4 55
7 3 5 10 6 9 11 1 21 7 10 6 14 9 167
Table7: How much do you agree or disagree that the little bit of smoke you inhale in public places where smoking is permitted is not enough to hurt you?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Strongly Disagree 5 7 3 8 2 1 3 0 1 2 1 Disagree 4 5 4 3 3 2 3 1 3 3 2 Agree 0 2 1 2 0 1 2 0 0 4 3 Strongly Agree 0 3 0 7 0 1 0 0 0 1 1 Page 44
Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
2 5 5 7 8 0 13 5 11 5 8 6 108
4 3 1 3 10 2 9 2 3 4 6 5 85
0 3 0 1 6 2 2 6 1 1 5 1 43
0 2 1 1 1 0 1 1 2 0 2 1 25
Table 8: How much do you agree or disagree that smokers have a right to smoke wherever they want?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Strongly Disagree 8 14 7 12 4 1 5 4 8 3 6 11 7 9 Disagree 0 2 1 2 1 1 0 0 1 3 0 2 0 2 Agree 1 1 0 3 0 1 0 0 1 1 0 0 0 0 Strongly Agree 0 0 0 2 0 1 3 0 0 0 0 0 0 0 Page 45
Maricopa:Western Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
16 3 21 12 11 6 13 11 192
5 1 3 2 3 1 7 1 38
2 0 0 0 0 3 0 0 14
2 0 0 0 2 0 1 1 12
Table 9: How much do you agree or disagree that the majority of Americans/my constituents support tobacco control?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Strongly Disagree 0/1 0/1 0/0 2/1 1/0 1/2 0/0 0/0 0/0 0/0 0/1 0/1 0/0 0/0 0/0 0/1 0/0 Disagree 2/0 7/12 1/2 8/5 0/1 1/1 0/1 0/1 0/0 2/1 1/2 1/0 2/4 1/3 3/2 10/10 1/2 Agree 4/5 8/4 4/4 5/9 2/3 3/2 6/4 1/0 4/4 2/5 5/4 2/4 9/7 1/2 4/5 11/8 3/2 Strongly Agree 3/3 2/0 3/2 3/3 2/1 0/0 2/2 0/0 0/0 6/4 1/0 2/0 3/3 5/1 5/4 4/6 0/0 Page 46
Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0/1 0/0 1/1 1/1 0/0 0/0 6/11
7/6 3/3 5/5 3/2 5/7 1/2 64/72
11/9 8/8 8/9 3/4 11/10 10/8 125/120
7/8 3/2 3/2 3/2 3/3 2/3 62/49
Table 10: How much do you agree or disagree that health issues should take precedence over business concerns in making decisions about public tobacco policies?
Local Project Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave Navajo Strongly Disagree 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 Disagree 0 3 0 4 1 1 0 1 0 2 3 1 1 0 0 6 1 2 Agree 4 6 2 6 3 3 2 0 3 3 2 2 7 2 2 8 2 11 Strongly Agree 5 7 6 9 1 0 5 0 1 5 2 3 5 5 10 10 1 12 Page 47
Pima Pinal Santa Cruz Yavapai Yuma Total
0 2 0 0 0 6
3 0 3 3 0 35
7 5 3 7 10 101
4 10 3 11 3 118
Table 11: Do you have staff support to gather information about policy issues being considered by the council/board? Local Project Never Sometimes Frequently Always Apache Cochise Coconino Gila Graham Greenlee LaPaz Maricopa (countywide) Maricopa: Mesa Maricopa: Northern Maricopa: Scottsdale Maricopa: SouthCentral Maricopa: Southeast Valley Maricopa: TAG/TUP Maricopa: TLC Maricopa:Western Mohave 0 2 0 4 1 2 1 0 0 2 0 0 0 1 0 2 0 3 1 1 5 2 1 2 0 0 0 0 1 0 0 2 2 1 1 2 4 4 0 1 1 1 0 1 0 0 4 2 4 5 1 5 12 3 7 2 1 5 0 4 5 7 4 8 4 5 16 3 Page 48
Navajo Pima Pinal Santa Cruz Yavapai Yuma Total
0 1 0 0 0 0 16
1 1 0 2 3 2 30
4 4 2 1 5 4 51
20 8 15 7 13 7 161
Table 12: How frequently do you use e-mail? Local Project Never Tried it Apache 2 0 Cochise 4 1 Coconino 0 1 Gila 5 2 Graham 0 0 Greenlee 3 0 LaPaz 2 0 Maricopa (countywide) 0 0 Maricopa: Mesa 0 0 Maricopa: Northern 3 1 Maricopa: Scottsdale 0 0 Maricopa: SouthCentral 0 1 Maricopa: Southeast Valley 1 1 Maricopa: TAG/TUP 3 0 Maricopa: TLC 2 1 Maricopa:Western 7 2 Mohave 3 0 Navajo 4 4 Pima 0 0 Pinal 7 1 Santa Cruz 6 1 Yavapai 3 1 Yuma 3 1 Total 58 18
Sometimes 0 5 2 5 2 1 2 1 2 2 0 0 0 0 2 0 0 5 1 1 0 4 4 39
Regularly 6 7 5 6 3 1 5 0 2 4 7 5 12 3 6 15 1 11 12 8 3 13 5 140
Page 49
Page 50